Asthma & Allergies

Azithromycin to Prevent Asthma Exacerbations

June 20, 2016
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By Philip R. Fischer, MD, DTM&H

Dr. Fischer is Professor of Pediatrics, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.

SYNOPSIS: Though this study shows that azithromycin aids in preventing upper-respiratory infection’s progression to wheezing among young children, further testing is required prior to the widespread implementation of azithromycin treatment for preschool-aged children with colds.

SOURCE: Bacharier LB, et al. Early administration of azithromycin and prevention of severe lower respiratory tract illnesses in preschool children with a history of such illnesses: A randomized clinical trial. JAMA 2015;314:2034-2044.

This multi-center study analyzed results gathered from 607 young children (average age: 41 months) with histories of recurrent wheezing triggered by respiratory infections who were treated with either azithromycin or a placebo following their next viral respiratory illness. After over a year of follow ups, 443 children sustained symptoms of another viral respiratory illness and were included in the analysis. All children in the study were given both scheduled and need-based bronchodilator doses at the onset of symptoms.

Study results showed that children treated with azithromycin were less likely to develop severe respiratory illnesses typified by wheezing than the placebo controls. The conditions of 33 children in the placebo group necessitated azithromycin treatment to avoid wheezing caused by serious respiratory infection. The developmental rates of subsequent respiratory illnesses and children’s liability to contract their next respiratory illness were not significantly different between the control group and the azithromycin group.