Azithromycin administered for acute bronchiolitis may have a protective effect on subsequent wheezing

Area of Science:

• Pediatrics
• Infectious Diseases
• Pharmacology

Background:

• Recurrent wheezing is a common sequela of acute bronchiolitis (AB) in infants.
• Emerging evidence suggests azithromycin may mitigate post-AB respiratory morbidity.
• The protective effect of azithromycin on subsequent wheezing and hospitalizations requires further investigation.

Purpose of the Study:

• To evaluate the efficacy of azithromycin in reducing recurrent wheezing after acute bronchiolitis.
• To determine if azithromycin administration during AB decreases subsequent hospital re-admissions.

Main Methods:

• Secondary analysis of a randomized, double-blind, placebo-controlled trial.
• Inclusion of unpublished data on wheezing and hospitalizations up to 6 months post-AB.
• Infants (<12 months) hospitalized with AB received oral azithromycin or placebo for 7 days.

Main Results:

• 104 infants were included (50 azithromycin, 54 placebo).
• At 3 months, the wheezing recurrence rate was significantly lower in the azithromycin group (RR = 0.48; p = 0.038).
• Data on hospital readmissions were collected via standardized questionnaires.

Conclusions:

• Azithromycin significantly reduces the risk of subsequent wheezing in the 0-3 month period post-hospitalization for acute bronchiolitis.
• The benefit of azithromycin was observed irrespective of respiratory syncytial virus (RSV) status.
• Azithromycin shows promise as a preventative therapy for post-bronchiolitis wheezing.