Azithromycin for Severe Respiratory Syncytial Virus Infection in Young Children

In a phase 2 controlled clinical trial, high-dose azithromycin for 3 days safely reduced hospital stay and endotracheal markers for viral replication.

Effective therapies for respiratory syncytial virus (RSV) infection, a major pediatric clinical problem, are not available. To assess the safety and potential effectiveness of azithromycin, researchers conducted a phase 2 double-blind controlled trial. Forty-eight children (median age, 12 months) with RSV requiring respiratory support (34 with mechanical ventilation, 2 bilevel positive airway pressure, 12 high-flow nasal cannula) were randomized to one of three arms: normal saline, standard-dose azithromycin (10 mg/kg/day), or high-dose azithromycin (20 mg/kg/day) intravenously for 3 days. Endotracheal or nasal matrix metalloproteinase (MMP) levels were assessed as a measure of viral replication.

At 72 hours, endotracheal MMP levels were sig…

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

Azithromycin for Severe Respiratory Syncytial Virus Infection in Young Children

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Reviewing Author