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Antibiotic may prevent severe respiratory illnesses in children

While increasing antibiotic resistance is a concern, early antibiotic treatment was shown to be significantly effective at preventing severe respiratory tract infections.

By Stephen Feller
Antibiotic may prevent severe respiratory illnesses in children
Researchers have tried using long-term asthma medications with children prone to respiratory infections when they get sick, however the drugs have little to no effect. Photo by Nataliia Zhekova/Shutterstock

WASHINGTON, Nov. 18 (UPI) -- Doctors are advised not to prescribe antibiotics for the common cold and other routine illnesses, however new research shows children prone to respiratory tract infections when they get sick could benefit from early treatment with azithromycin.

As many as half of all children in the United States have at least one wheezing episode before they turn 6 and one-third of preschool children have had an episode during the last six months, making it a serious concern.

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Researchers propose treating children who regularly wheeze when they are sick with "a strong dose" of azithromycin after finding it can prevent colds from progressing in a study published in the Journal of the American Medical Association.

During the last decade, clinical trials have tested conventional asthma therapies both continuously over long periods of time and intermittently when wheezing episodes occur, finding the treatment made basically no difference, according to an editorial published with the study.

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"These kids are basically fine until they get a cold, and then every time they get a cold it goes into their chest and causes wheezing," said Dr. Robyn Cohen, an assistant professor of pediatrics at Boston University School of Medicine, told HealthDay.

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Researchers recruited 607 children between the age of 12 months and 71 months with histories of recurrent, severe lower respiratory tract illness. Participants were split into two groups, with 307 receiving 12 mg of azithromycin for five days and 300 being given a placebo. Each child was treated based on an individual plan for a 12- to 18-month period.

The children had a total of 937 respiratory illnesses, including 92 that were severe. Of those cases, 35 were in the group receiving azithromycin, compared to 57 children who got the placebo. Children who received azithromycin at the onset of a cold had a 36 percent lower risk of progressing to a severe respiratory tract illness, compared to children receiving the placebo.

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While it was shown to be an effective treatment, azithromycin is known to cause antibiotic resistance, and bacteria resistant to the drug were found in children in both groups during the study. While those who received the antibiotic were more likely to have resistant bacteria in their bodies, researchers said they were unsure about the long-term effects either on the children or on the efficacy of the drug.

"We don't know how long [that resistant organism] does or does not stick around," said Dr. Leonard Bacharier, clinical director of allergy, immunology and pulmonary medicine at Washington University School of Medicine in St. Louis. "Are those children at greater risk of having more infections down the road? We just don't know."

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