Azithromycin Prophylaxis to Prevent Childhood Mortality — Take 4

In 2009, researchers reported that a trial of mass administration of azithromycin to prevent trachoma in Ethiopia also showed markedly reduced childhood mortality (NEJM JW Infect Dis Dec 2009 and JAMA 2009; 302:962). Later, a cluster-randomized trial involving community randomization performed in Niger, Malawi, and Tanzania (MORDOR I) also showed a reduction in mortality with azithromycin prophylaxis (NEJM JW Infect Dis Jul 2018 and N Engl J Med 2018; 378:1583). However, in a randomized trial in Burkina Faso and Mali, addition of azithromycin prophylaxis to malaria chemoprophylaxis reduced childhood morbidity but not childhood mortality (NEJM JW Infect Dis Apr 2019 and N Engl J Med 2019 Jan 30; [e-pub].)

Now, Keenan and collaborators report …