Mass Azithromycin Use Increases Both Macrolide and Nonmacrolide Resistance Genes

Azithromycin administration twice yearly for 4 years to children younger than 5 years old in Niger led to increases in resistance determinants to multiple classes of antibiotics.

Mass administration of azithromycin to young children has been shown to reduce childhood mortality in sub-Saharan Africa (NEJM JW Infect Dis Aug 2019 and N Engl J Med 2019; 380:2207 and N Engl J Med 2019; 380:2271). But what are the longer-term consequences? To assess the effect of twice-yearly azithromycin administration on the gut resistome, investigators enrolled 30 villages in Niger. Villages were randomly assigned to receive mass distribution of azithromycin (industry provided) or placebo, administered to all children aged 1 to 59 months every 6 months for 4 years. At baseline, 36 months, and 48 months rectal swabs were collected. Forty samples from children in each village were pooled for sequencing and analysis for presence of antibi…

Reviewing Author

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Mass Azithromycin Use Increases Both Macrolide and Nonmacrolide Resistance Genes

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Reviewing Author