Single dose azithromycin to prevent cholera in children

单剂量阿奇霉素预防儿童霍乱

• 批准号: 10462780
• 负责人: JASON B HARRIS
• 金额: $ 57.36万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-05 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10462780
• 关键词: Address; Advisory Committees; Age; Antibiotic Prophylaxis; Antibiotic Resistance; Antibiotic Therapy; Antibiotics; Antimicrobial Resistance; Area; Azithromycin; Bacteria; Bacterial Antibiotic Resistance; Bangladesh; Case Study; Cessation of life; Chemoprophylaxis; Child; Cholera; Cholera Vaccine; Clinical; Cluster randomized trial; Data; Dehydration; Detection; Development; Diarrhea; Disease; Dose; Education; Enrollment; Environment; Epidemic; Feces; Future; Goals; Hour; Household; Hygiene; IV Fluid; Infection; Intervention; Knowledge; Measures; Metagenomics; Molecular; Monitor; Only Child; Oral; Outcome; Participant; Patient Self-Report; Patients; Placebos; Prevention; Prevention strategy; Prophylactic treatment; Prospective Studies; Public Health Practice; Randomized; Research; Research Design; Risk; Sanitation; Severities; Site; Symptoms; Testing; Time; Vaccines; Variant; Vibrio cholerae; Vibrio cholerae O1; Vibrio cholerae infection; Visit; Vomiting; Water; World Health Organization; Yemen; antigen test; base; clinical care; clinical practice; cooking; effectiveness measure; effectiveness testing; group intervention; gut bacteria; high risk; improved; indexing; infection risk; intervention effect; liquid chromatography mass spectroscopy; member; mortality; placebo group; post intervention; prevent; prophylactic; prospective; rapid diagnosis; standard of care; transmission process

PROJECT SUMMARY Vibrio cholerae causes 3 million cases of cholera and 100,000 deaths annually. Young children are most vulnerable to cholera, yet they are not protected by current vaccines. More aggressive approaches are needed to prevent the cholera, especially in young children. To meet this challenge, the World Health Organization has targeted the elimination of the global threat of cholera transmission by the year 2030, but the strategic approach to achieve this ambitious goal has not yet been determined. For patients with cholera, effective antibiotic treatment dramatically reduces the severity of infection and prevents the release of trillions of V. cholerae bacteria into the environment. However, while antibiotics are often effectively used to prevent other infections, there are no standards for the use of antibiotics to prevent cholera. As a result, there is tremendous variation in practice, and antibiotics with unproven efficacy are frequently given to prevent cholera. These unproven approaches may needlessly contribute to antibiotic resistance in both V. cholerae and important bystander bacteria as well. For this reason, the World Health Organization Task Force on Cholera Control has recommended a halt to widespread antibiotic use for preventing cholera, and instead recommends that studies be done to test the effectiveness of antibiotics for cholera prevention as well as their impact of this on antimicrobial resistance. Our proposal addresses this exact knowledge gap. We will determine whether single-dose azithromycin is effective in preventing V. cholerae infection in children who live in a household where there has been a case of cholera. Without intervention, these children have a 30% chance of developing infection within one week. While a single-dose of azithromycin is a preferred treatment for cholera, azithromycin to prevent cholera has never been studied. Azithromycin has been found to be beneficial in other mass prevention studies in children, but the impact of single-dose of azithromycin on antibiotic resistance has not been sufficiently tested. We anticipate that this study will result in the more effective and judicious use of antibiotics to prevent cholera in children.

项目总结