Role of atypical bacteria and azithromycin therapy for children with recurrent respiratory tract infections

Susanna Esposito, Samantha Basis, Nadia Faelli, Enrica Begliatti, Roberta Droghetti, Elena Tremolati, Alessandro Porta, Francesco Blasi, Nicola Principi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aim of this study of 352 patients, 1-14 years of age, with acute respiratory infections and a history of recurrent respiratory tract infections (RRTIs), and 208 healthy subjects was to evaluate whether Mycoplasma pneumoniae and Chlamydia pneumoniae played a role in causing acute respiratory episodes among children with RRTIs and whether specific antibiotic treatment for these bacteria could improve the acute episodes and reduce recurrences. Methods: The patients were blindly randomized to receive azithromycin (10 mg/kg/d for 3 days weekly, for 3 weeks) together with symptom-specific agents or symptom-specific agents alone. Acute M. pneumoniae and/or C. pneumoniae infection was diagnosed if the child had a significant antibody response in paired sera and/or if the DNA of the bacteria was detected in nasopharyngeal aspirates. Results: Atypical bacterial infections were identified for 190 patients (54.0%) and 8 healthy control subjects (3.8%; P <0.0001). Short term (1-month) clinical success was significantly more frequent among the patients who had received azithromycin together with symptom-specific agents than among those who had received symptom-specific agents alone, but the difference was significant only for the group of patients with atypical bacteria. In contrast, long term (6-month) clinical success was significantly more frequent among the patients who had received azithromycin in addition to symptom-specific agents, regardless of whether they experienced infections with atypical bacteria or other pathogens, although positive outcomes were significantly more frequent among those with atypical bacteria. Conclusions: Atypical bacteria seem to play a role among children with RRTIs, and prolonged azithromycin therapy can significantly improve the acute episodes and reduce the risk of recurrences.

Original languageEnglish
Pages (from-to)438-444
Number of pages7
JournalPediatric Infectious Disease Journal
Volume24
Issue number5
DOIs
Publication statusPublished - May 2005

Keywords

  • Atypical bacteria
  • Azithromycin
  • Chlamydia pneumoniae
  • Mycoplasma pneumoniae
  • Recurrent respiratory tract infections

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

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