Azithromycin to Prevent Recurrent Wheeze Following Severe Respiratory Syncytial Virus Bronchiolitis.
Azithromycin to Prevent Recurrent Wheeze Following Severe Respiratory Syncytial Virus Bronchiolitis.
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DOI：
10.1056/evidoa2100069
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发表时间：
2022-04-01
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影响因子：
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通讯作者：
Bacharier, Leonard B
中科院分区：
文献类型：
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作者：
Beigelman, Avraham;Srinivasan, Mythili;Bacharier, Leonard B
背景：生命早期严重呼吸道合胞病毒（RSV）细支气管炎是儿童哮喘的危险因素。由于阿奇霉素可能会减轻 RSV 细支气管炎期间的气道炎症，因此我们评估了它是否会减少 RSV 后复发性喘息的发生。 方法：在这项单中心、双盲、安慰剂对照研究中，我们前瞻性地招募了 200 名因 RSV 细支气管炎而住院的其他方面健康的 1 至 18 个月大儿童，并随机分配他们接受口服阿奇霉素（每日 10 毫克/公斤，每日 10 毫克/公斤） 7 天，然后每天 5 mg/kg，持续 7 天）或安慰剂。随机化是根据最近开放标签抗生素的使用进行分层的。主要结果是复发性喘息的发生，定义为在接下来的 2 至 4 年内出现第三次 RSV 后喘息。 结果：作为阿奇霉素生物活性的指标，随机化后第 14 天的鼻洗液白细胞介素 8 水平在阿奇霉素治疗的参与者中较低（P
BACKGROUND: Early-life severe respiratory syncytial virus (RSV) bronchiolitis is a risk factor for childhood asthma. Because azithromycin may attenuate airway inflammation during RSV bronchiolitis, we evaluated whether it would reduce the occurrence of post-RSV recurrent wheeze.METHODS: We prospectively enrolled 200 otherwise healthy 1- to 18-month-old children hospitalized with RSV bronchiolitis in this single-center, double-blind, placebo-controlled study and randomly assigned them to receive oral azithromycin (10 mg/kg daily for 7 days, followed by 5 mg/kg daily for 7 days) or placebo. Randomization was stratified by recent open-label antibiotic use. The primary outcome was the occurrence of recurrent wheeze, defined as a third episode of post-RSV wheeze over the following 2 to 4 years.RESULTS: As an indication of the biologic activity of azithromycin, nasal wash interleukin-8 levels, at day 14 after randomization, were lower among azithromycin-treated participants (P