Clarithromycin in Preventing Bronchopulmonary Dysplasia in Ureaplasma urealyticum–Positive Preterm Infants

Abstract

Clarithromycin treatment prevents development of BPD in preterm infants who are born at 750 to 1250 g and colonized with U urealyticum.

Pharmacokinetics, Microbial Response, and Pulmonary Outcomes of Multidose Intravenous Azithromycin in Preterm Infants at Risk for Ureaplasma Respiratory Colonization

“…in in vitro (5,6) and in in vivo experimental models (7)(8)(9). Although the efficacies of azithromycin and a related macrolide, clarithromycin, to prevent BPD have been assessed in single-center studies of preterm infants (10)(11)(12)(13), the optimal dosing regimens for these antibiotics have not been determined in pharmacokinetics (PK) and pharmacodynamic studies, and the impacts on long-term pulmonary and neurologic outcomes are unknown. Our first steps to address these questions have been to conduct studies in the at-risk population to determine the optimal dose, safety, and in vivo anti-infective efficacy of azithromycin in preparation for future phase III randomized, placebo-controlled trials (14,15).…”

Azithromycin To Prevent Bronchopulmonary Dysplasia in Ureaplasma-Infected Preterm Infants: Pharmacokinetics, Safety, Microbial Response, and Clinical Outcomes with a 20-Milligram-per-Kilogram Single Intravenous Dose

“…Although the efficacy of azithromycin and a related macrolide, clarithromycin, to prevent BPD has been assessed in single-center studies of at-risk preterm infants (11,12), the optimal dosing regimens for these antibiotics have not been determined in pharmacokinetic and pharmacodynamic studies. Recently, we characterized the pharmacokinetics (PK) of a single dose of intravenous (i.v.)…”

Neonatal Pneumonia

“…In patients where we suspect or diagnose an U infection we initiate treatment with intravenous clarithromycin (10mg/kg/day), a macrolid antibiotic. In a recently published randomized controlled placebo single-center study clarithromycin treatment resulted in eradication of Uu in 68,5 % of the patients and a significantly lower incidence of BPD (2.9% vs. 36.4%) in preterm infants weighing between 750 to 1250 g (28). Azithromycin, another macrolid antibiotic, which has good inhibitory activity against Ureaplasma in in-vitro studies, may also be beneficial for BPD prevention in Ureaplasma colonized/infected preterm infants, especially when used early and for longer duration (29).…”