Azithromycin therapy during respiratory syncytial virus bronchiolitis: Upper airway microbiome alterations and subsequent recurrent wheeze

[...]the mechanism of AZM's anti-inflammatory effects may have reflected direct effects on the immune response, or an indirect effect through antibacterial actions of AZM leading to alteration in bacteria abundance and a reduction in neutrophilic inflammation. [...]it remains imperative to investigate whether the potential beneficial effects of AZM for the prevention of post-RSV wheezing are related, at least in part, to its antibacterial effects. Characteristic All participants AZM group (n = 19) Placebo group (n = 20) Age at enrollment (mo)[low *] 3.8 ± 2.9 3.7 ± 3.7 3.9 ± 2.0 Sex: Male 59.0% 47.4% 70.0% Race White 64.1% 63.2% 65.0% Black 35.9% 36.8% 35% Birth weight (kg)[low *] 3.4 ± 0.5 3.3 ± 0.6 3.4 ± 0.4 Length of pregnancy (wk)[low *] 38.8 ± 1.4 38.9 ± 1.3 38.7 ± 1.4 Maternal smoking during pregnancy 7.7% 10.5% 5.0% History of breast-feeding 28.2% 31.6% 25.0% Tobacco smoke exposure 35.9% 42.1% 30% Pet exposure 61.5% 63.1% 60.0% History of eczema 17.9% 21.1% 15.0% Parental history of asthma 41.0% 42.1% 40.0% Duration of respiratory symptoms before randomization (d)[low *] 5.4 ± 1.4 5.2 ± 1.3 5.5 ± 1.4 Duration of hospitalization (h)[low *] 63.4 ± 53.2 58.0 ± 41.4 68.5 ± 63.2 Lowest O2 saturation on room air[low *] 90.8 ± 4.3 91.4 ± 4.9 90.3 ± 3.6 Table I Baseline characteristics of the APW-RSV study participants Data are expressed as proportion of children in each group except as noted.