Single dose azithromycin to prevent cholera in children

项目总结 霍乱弧菌每年导致300万霍乱病例和10万人死亡。年幼的孩子最多 他们很容易感染霍乱，但目前的疫苗没有保护他们。需要采取更积极的方法 以预防霍乱，特别是在幼儿中。为了迎接这一挑战，世界卫生组织已经 目标是到2030年消除霍乱传播的全球威胁，但战略 实现这一雄心勃勃的目标的方法尚未确定。 对于霍乱患者，有效的抗生素治疗大大降低了感染的严重性和 防止数万亿霍乱弧菌释放到环境中。然而，虽然抗生素是 抗生素通常被有效地用来预防其他感染，但对于使用抗生素来预防 霍乱。因此，在实践中存在着巨大的差异，而疗效未经证实的抗生素是 经常用来预防霍乱。这些未经证实的方法可能会不必要地助长抗生素的产生 霍乱弧菌和重要的旁观者细菌也都具有耐药性。因此，世界卫生组织 霍乱控制组织特别工作组建议停止广泛使用抗生素 预防霍乱，并建议进行研究，以测试抗生素对 霍乱的预防及其对抗菌素耐药性的影响。 我们的建议解决了这一确切的知识鸿沟。我们将确定单剂阿奇霉素是否 有效预防霍乱弧菌感染家庭儿童感染霍乱弧菌 霍乱。如果不进行干预，这些儿童有30%的机会在一周内发展为感染。 虽然单剂阿奇霉素是治疗霍乱的首选药物，但预防霍乱的阿奇霉素 从未被研究过。阿奇霉素已经被发现在儿童的其他集体预防研究中是有益的， 但单剂阿奇霉素对抗生素耐药性的影响还没有得到充分的测试。我们 预计这项研究将导致更有效和明智地使用抗生素来预防霍乱 孩子们。

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.