Which Antibiotic Is Best for Bronchiectasis Exacerbations Unrelated to Cystic Fibrosis?

Bronchiectasis in children is rare when not associated with cystic fibrosis. Current first-line therapy is oral amoxicillin-clavulanate twice daily. Researchers in Australia and New Zealand conducted a noninferiority, double-blind, randomized, controlled trial to compare once-daily oral azithromycin with twice-daily oral amoxicillin clavulanate for resolution of nonsevere exacerbations in children with bronchiectasis. A total of 179 children received either amoxicillin clavulanate (22.5 mg/kg) plus placebo twice daily or azithromycin (5 mg/kg) plus placebo once daily for 21 days.

Exacerbations resolved within 21 days in 84% of patients in both groups. Median time to resolution was significantly shorter in the amoxicillin-clavulanate group th…