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Antibiotics help prevent recurrent wheezing among kids, making corticosteroids redundant, a recent study has shown. The findings were published on November 17, in the Journal of the American Medical Association.
A team of researchers, led by Leonard Bacharier, professor of pediatrics at Washington University School of Medicine in St. Louis, conducted a randomized controlled trial involving 607 children.
The participants, aged between 12 months and 6 years, had been selected because their medical records had shown they had a history of respiratory illness.
When they began showing the first signs of a cold, some of the patients were administered a placebo, while others were given azithromycin (commercialized as Zmax or Zithromax).
In total, 937 respiratory tract illnesses occurred, among 443 of the subjects, and although the number of colds had been similar between the two randomly assigned groups, overall progression varied significantly.
Of the 92 participants whose condition worsened, until they eventually developed severe lower respiratory tract infections (such as pneumonia), 57 had been part of the controlled group who had only taken a placebo, while 32 had been the ones who were given azithromycin.
In other words, those who had been administered this antibiotic during the early stages of a cold had a 36% lower probability of suffering complications, in comparison with those who hadn’t benefited from this treatment.
Therefore, study authors recommend that for children who are more at risk of developing pneumonia and other types of lower respiratory tract infections, it might be preferable to take azithromycin from the early signs of a cold.
Such advice might be surprising to some, given that it has been well-documented that antimicrobials taken too frequently or indiscriminately lead to an alarming number of superbugs, due to growing antibiotic resistance.
This is especially important, since this particular drug has been proven to cause the emergence of bacteria which no longer responds to treatment later on.
On the other hand, overly vulnerable children whose colds always degenerate into more serious conditions might benefit by taking azithromycin, study authors insist.
Around a quarter of all kids younger than 6 experience recurrent wheezing and other symptoms associated with chest infections, precisely because their body isn’t capable of defending itself adequately against upper respiratory tract illnesses, such as laryngitis or tonsillitis.
Therefore, a heavy, early dose of antibiotics at the beginning of a cold might seem counter-intuitive, but could actually help reduce the incidence of more severe conditions.
According to researchers, this type of treatment might lower the need for corticosteroids, such as methylprednisolone or prednisone, which are commonly prescribed nowadays in order to combat frequent wheezing.
Oral corticosteroids are used so as to prevent asthma, by reducing chronic inflammation and opening up airways, but they don’t always yield the desired results, especially among young kids.
Azithromycin would make these drugs unnecessary, by stopping colds from advancing and affecting the lower respiratory tract as well.
Overall drug tolerability is high, adverse reactions are minimal (diarrhea, nausea, headache), and the antibiotic is also widely available and cheap enough so that it can be extremely accessible.
Nevertheless, concerns still remain regarding the possibility that azithromycin might help create bacteria that’s immune to conventional treatment,. Therefore, study authors are now planning further research, to assess the long-term implications of this drug therapy when it comes to the creation of deadly superbugs.
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