A randomized, single-center study has noted that azithromycin given for severe early-life bronchiolitis due to respiratory syncytial virus (RSV) did not prevent recurrent wheezing in children over the next 2-4 years.

The study included 200 otherwise healthy babies, aged between 1 and 18 months, who were hospitalized at St. Louis Children′s Hospital for acute RSV bronchiolitis. Babies were randomized to receive placebo or oral azithromycin 10 mg/kg daily for 1 week, followed by 5 mg/kg daily for a week. The primary outcome was recurrent wheeze, which was characterized by a third episode of post-RSV wheeze over the next 2-4 years. The risk of post-RSV recurrent wheeze appeared to be similar in both the groups - 47% in the azithromycin group compared to 36% in the placebo group, with an adjusted hazard ratio of 1.45.

Azithromycin did not reduce the risk of recurrent wheeze in babies already receiving other antibiotics at the time of recruitment (HR, 0.94). Among the antibiotic-naive babies who received azithromycin, there was a slight increase in the risk of developing recurrent wheezing (HR, 1.79).

The study was presented at the 2022 meeting of the American Academy of Allergy, Asthma & Immunology, and was simultaneously published in the New England Journal of Medicine–Evidence… (Medscape)