Single dose azithromycin to prevent cholera in children

项目摘要 霍乱弧菌每年造成300万例霍乱和10万人死亡。幼儿最 他们很容易感染霍乱，但目前的疫苗却不能保护他们。需要采取更积极的方法 以预防霍乱，尤其是儿童。为了应对这一挑战，世界卫生组织 目标是到2030年消除霍乱传播的全球威胁， 实现这一宏伟目标的方法尚未确定。 对于霍乱患者，有效的抗生素治疗可显著降低感染的严重程度， 阻止了数万亿的霍乱弧菌释放到环境中。虽然抗生素是 通常有效地用于预防其他感染，没有标准的使用抗生素，以防止 霍乱。因此，在实践中存在巨大的变化，并且具有未经证实的功效的抗生素被广泛使用。 常用于预防霍乱。这些未经证实的方法可能不必要地有助于抗生素 霍乱弧菌和重要的旁观者细菌的耐药性。为此，世界卫生组织 霍乱控制工作组建议停止广泛使用抗生素， 预防霍乱，而是建议进行研究，以测试抗生素的有效性， 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差距。我们将确定单剂量阿奇霉素是否 有效预防儿童感染霍乱弧菌， 霍乱。如果不进行干预，这些儿童有30%的机会在一周内发生感染。 虽然单剂量阿奇霉素是霍乱的首选治疗方法，但阿奇霉素预防霍乱的效果不佳， 从未被研究过。阿奇霉素已被发现是有益的其他大规模预防研究的儿童， 但是单剂量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

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.