2015
DOI: 10.1001/jama.2015.13896
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Abstract: IMPORTANCE Many preschool children develop recurrent, severe episodes of lower respiratory tract illness (LRTI). Although viral infections are often present, bacteria may also contribute to illness pathogenesis. Strategies that effectively attenuate such episodes are needed. OBJECTIVE To evaluate if early administration of azithromycin, started prior to the onset of severe LRTI symptoms, in preschool children with recurrent severe LRTIs can prevent the progression of these episodes. DESIGN, SETTING, AND PA… Show more

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Cited by 240 publications
(172 citation statements)
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References 30 publications
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“…Is there a role for antibiotics in the treatment of bronchiolitis? Despite recent studies showing some efficacy of azithromycin in the treatment of preschool wheeze (13,14), previous studies of RSV do not support this approach (15). If bacteria are contributing to bronchiolitis, perhaps their effects start early in the course of the illness so that the window of opportunity has elapsed once lower-airway symptoms are present.…”
mentioning
confidence: 99%
“…Is there a role for antibiotics in the treatment of bronchiolitis? Despite recent studies showing some efficacy of azithromycin in the treatment of preschool wheeze (13,14), previous studies of RSV do not support this approach (15). If bacteria are contributing to bronchiolitis, perhaps their effects start early in the course of the illness so that the window of opportunity has elapsed once lower-airway symptoms are present.…”
mentioning
confidence: 99%
“…Macrolides are frequently prescribed for cystic fibrosis and COPD due to their anti-inflammatory properties and may have a role in treatment of recurrent wheezing and asthma as well. Bacharier et al conducted a randomized, double-blinded trial of preschool children, half of whom had a positive modified API, using early administration of azithromycin 12 mg/kg for 5 days or placebo at the onset of respiratory illness and found a reduction in episodes of severe lower airway respiratory illness in the azithromycin group compared to placebo (50). Subgroup analyses found no significant effect of API on response to azithromycin.…”
Section: Macrolidesmentioning
confidence: 99%
“…However, whether this should be widely adopted or used in special groups (frequent or severe episodes) is unclear. Another multicentre study showed a reduced likelihood of severe illness in those children with recurrent severe wheezing who were treated with azithromycin early in their illness 24. It is uncertain whether this effect is immunologically, or microbiologically mediated.…”
Section: Pharmacological Treatmentmentioning
confidence: 99%