Early Antibiotic Treatment May Reduce Severe Respiratory Illness In Children

A new study found that administering antibiotics early in life may help children reduce severe respiratory illnesses.

A significant number of preschool children, aged between 4 to 6 years, old exhibit severe and on and off episodes of lower respiratory tract illness (LRTI). Approximately 14 to 26 percent of this population are also said to have recurrent wheezing during the first six years of life.

The most common culprit for such illnesses are viruses, but bacteria may also play a part in the disease process. With this, a group of American researchers delved into the possible strategies that can help halt these episodes.

For the study, the authors wanted to specifically determine if administration of antibacterial drug azithromycin prior to LRTI symptoms can reduce the development and prevent the progression of recurrent and severe LRTIs in preschool children.

The researchers performed the study by conducting a placebo-controlled, double-blind trial across nine American medical facilities, with an enrollment date of April 2011 and a follow-up date of December 2014.

The total number of participants was 607 and were all aged between 12 to 71 months. History review revealed that all the study subjects had severe, recurrent LRTIs and slight daily impairments.

The participants were randomly assigned to receive either azithromycin or a placebo. The administration of the drugs was initiated during each child's predefined respiratory tract illness (RTI), or the period before LRTI symptoms developed. The highest dose of antibiotic was used so as to maximize its inflammatory effects.

All in all, 937 episodes of RTIs and 92 episodes of severe LRTIs were experienced by 443 children in both groups respectively

The researchers said that azithromycin drastically decreased the risk of LRTIs progressing to the severe form, relative to placebo.

Questions of antibiotic resistance cropped up thus, the researchers further investigated azithromycin resistance in a subset of 86 patients. "We saw that there were children who received azithromycin during the study who, at the end of the study, had azithromycin-resistant germs in their throats," said lead author Leonard B. Bacharier from the University of Washington Medical School.

Bacharier explained, however, that the team was also able to observe similar rates of azithromycin-resistant bacteria in participants, who did not receive the antibiotic. With this, they cannot fully establish the impact of azithromycin on the issue.

In the future, the researchers would like to study the effects of the experiment on children whose disease severity is one notch higher than the present study group.

The study was published in the Journal of the American Medical Association (JAMA) on Tuesday, Nov. 17.

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