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Azithromycin to Keep Kids from Wheezing

Preschool children with a history of wheezing and respiratory trouble after a cold were much less prone to this complication if they took azithromycin.

Young children get a great many colds at this time of year, but there are not good medications to treat them. Over-the-counter cold medicines do more harm than good for little kids. In addition, pediatricians have been advised by their professional organization to avoid prescribing antibiotics for viral infections. Most children’s sniffles and sneezes are probably caused by viruses.

Could Azithromycin Keep a Cold from Progressing to Wheezing?

Now a study published in JAMA shows that some preschoolers may actually benefit from a course of azithromycin (Zithromax).

Some youngsters have a history of lower respiratory tract infections and wheezing following colds. The usual course of treatment for lower respiratory infections has been corticosteroids like prednisone. Such treatment carries the risk of side effects and doesn’t work all that well for young children.

Randomized Clinical Trial of Antibiotic:

The study compared treatment with the antibiotic azithromycin to placebo in over 600 young children with this dangerous history. They were treated at the first symptoms of an upper respiratory tract infection that had led to severe wheezing in the past.

Those who received azithromycin were less likely to need oral corticosteroids and had less severe symptoms. The researchers also looked for evidence that azithromycin treatment led to antibiotic-resistant bacteria and found little to worry them.

JAMA, Nov. 17, 2015

This treatment should be restricted to the small population of youngsters who progress quickly from sneezing to wheezing. Azithromycin in adults has the potential to cause a rare but fatal reaction affecting the heart, but no one knows if this serious adverse effect might also apply to young children.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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