Single dose azithromycin to prevent cholera in children

单剂量阿奇霉素预防儿童霍乱

• 批准号: 10632107
• 负责人: JASON B HARRIS
• 金额: $ 56.65万
• 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/10632107
• 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; Eligibility Determination; 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; Recommendation; Research Design; Research Priority; Risk Reduction; 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; 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; trial enrollment

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.

项目概要 霍乱弧菌每年导致 300 万例霍乱病例和 10 万人死亡。年幼的孩子最多 容易感染霍乱，但目前的疫苗无法保护他们。需要更积极的方法 预防霍乱，尤其是幼儿。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，但战略 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着降低感染的严重程度， 防止数万亿霍乱弧菌释放到环境中。然而，尽管抗生素 通常可有效用于预防其他感染，但目前尚无使用抗生素来预防的标准 霍乱。因此，实践中存在巨大差异，并且功效未经证实的抗生素被广泛使用。 经常预防霍乱。这些未经证实的方法可能不必要地促进抗生素的使用 霍乱弧菌和重要的旁观细菌也具有耐药性。为此，世界卫生组织 霍乱控制组织工作组建议停止广泛使用抗生素 预防霍乱，并建议进行研究来测试抗生素的有效性 霍乱预防及其对抗菌素耐药性的影响。 我们的提案解决了这个确切的知识差距。我们将确定单剂量阿奇霉素是否有效 可有效预防曾出现过霍乱弧菌病例的家庭中的儿童感染霍乱弧菌 霍乱。如果不进行干预，这些儿童有 30% 的几率在一周内发生感染。 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作用 从未被研究过。在其他儿童大规模预防研究中发现阿奇霉素有益， 但单剂量阿奇霉素对抗生素耐药性的影响尚未得到充分测试。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。