Azithromycin for Preventing Bronchopulmonary Dysplasia in Extremely Preterm Infants: A Cohort Study

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Yali Zeng1, Zhifeng Huang1, Yanqiong Wang1

  • 1Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, the First School of Medicine, Southern Medical University, Shenzhen, China.

Pediatric Pulmonology
|November 6, 2024
PubMed

Insights

Azithromycin significantly reduced the risk of bronchopulmonary dysplasia (BPD) in extremely preterm infants (EPI) without pulmonary infection. This finding suggests a potential benefit of azithromycin in preventing BPD in this vulnerable population.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication in extremely preterm infants (EPI).
  • Ureaplasma species colonization is a known risk factor for BPD in EPI.
  • The prophylactic or therapeutic role of azithromycin in preventing BPD remains an area of investigation.

Purpose of the Study:

  • To evaluate the effect of azithromycin on the incidence of grade II or higher BPD in EPI.
  • To determine if azithromycin treatment, specifically for Ureaplasma species colonization, is associated with a reduced risk of BPD in EPI without other pulmonary infections.

Main Methods:

  • Retrospective cohort study of 237 EPIs from September 2018 to September 2022.
  • Infants were categorized into two groups: azithromycin treatment (Ureaplasma species colonization) and no azithromycin treatment (Ureaplasma species negative).
  • Logistic regression analysis was employed to assess the association between azithromycin treatment and grade II+ BPD, adjusting for potential confounders.

Main Results:

  • Azithromycin treatment was associated with a significantly lower rate of grade II+ BPD (8.6% vs. 31.2%, p=0.006).
  • Infants receiving azithromycin also had a shorter duration of invasive ventilation (0 vs. 3 days, p=0.045).
  • Adjusted analysis confirmed azithromycin treatment was significantly associated with reduced BPD risk (OR 0.211) in the whole cohort and in infants without other pulmonary infections (OR 0.115).

Conclusions:

  • Azithromycin administration is associated with a decreased risk of developing grade II+ BPD in extremely preterm infants.
  • The anti-inflammatory properties of azithromycin may contribute to its protective effect against BPD.
  • These findings support the consideration of azithromycin for Ureaplasma-colonized EPIs to potentially prevent BPD.
Abstract

Keywords:
Ureaplasmainflammationlungnewborn

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