FRIDAY, May 22, 2026 (NewsDay News) — For preschool children who present to the emergency department with moderate to severe wheezing, azithromycin does not reduce the severity of respiratory symptoms, according to a study published online May 18. New England Journal of Medicine.
Kurt R. Denninghoff, PhD, from the University of Arizona in Tucson and colleagues randomly assigned patients aged 18 to 59 months who presented to the emergency department with a moderate to severe episode of dyspnea to receive azithromycin once daily (12 mg/kg body weight) or a matching placebo for five days. Total score on the Asthma Exacerbation Diary for Young Children (ADYC) over five days was assessed as the primary outcome.
In total, 521 of 840 randomly assigned patients tested positive for pathogenic bacteria. After a planned interim analysis, the trial was terminated for futility. The researchers observed a significant difference in ADYC scores between the azithromycin and placebo groups in either the positive cohort or the negative cohort. In the positive cohort, bacterial clearance was 58.7% and 11.4% in the azithromycin and placebo groups, respectively. For both groups, two groups had higher secondary outcomes, development of bacterial resistance and adverse events.
“The fact that children with pathogenic bacteria did not respond to antibiotics – even if we eliminated the bacteria – undermines the idea that bacteria cause respiratory failure,” said lead author Fernando D. Martinez, MD, also of the University of Arizona, said in a statement. “The bacteria are probably there because the kids have sensitivities.”
Two authors revealed the connection with the biopharmaceutical industry and medical technologies.
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