OBJECTIVE: To evaluate the efficacy and safety of clarithromycin treatment in preventing bronchopulmonary dysplasia (BPD) in Ureaplasma urealyticum-positive preterm infants. PATIENTS AND METHODS: Nasopharyngeal swabs for U urealyticum culture were taken from infants with a birth weight between 750 and 1250 g in the first 3 postnatal days. Infants with a positive culture for U urealyticum were randomly assigned to 1 of 2 groups to receive either intravenous clarithromycin or placebo. All the patients were followed at least up to the 36th postmenstrual week. RESULTS: A total of 224 infants met the eligibility criteria of the study. Seventy-four (33%) infants had a positive culture for U urealyticum in the first 3 day cultures. The rate of BPD development was significantly higher in patients with U urealyticum positivity (15.9% vs 36.4%; P < .01). However, multivariate logistic regression analysis failed to reveal a significant association between the presence of U urealyticum and BPD development (odds ratio: 2.4 [95% confidence interval: 0.9-6.3]; P = .06). Clarithromycin treatment resulted in eradication of U urealyticum in 68.5% of the patients. The incidence of BPD was significantly lower in the clarithromycin group than in the placebo group (2.9% vs 36.4%; P < .001). Multivariate logistic regression analysis confirmed the independent preventive effect of clarithromycin for the development of BPD (odds ratio: 27.2 [95% confidence interval: 2.5-296.1]; P = .007). CONCLUSIONS:Clarithromycin treatment prevents development of BPD in preterm infants who are born at 750 to 1250 g and colonized with U urealyticum.
RCT Entities:
OBJECTIVE: To evaluate the efficacy and safety of clarithromycin treatment in preventing bronchopulmonary dysplasia (BPD) in Ureaplasma urealyticum-positive preterm infants. PATIENTS AND METHODS: Nasopharyngeal swabs for U urealyticum culture were taken from infants with a birth weight between 750 and 1250 g in the first 3 postnatal days. Infants with a positive culture for U urealyticum were randomly assigned to 1 of 2 groups to receive either intravenous clarithromycin or placebo. All the patients were followed at least up to the 36th postmenstrual week. RESULTS: A total of 224 infants met the eligibility criteria of the study. Seventy-four (33%) infants had a positive culture for U urealyticum in the first 3 day cultures. The rate of BPD development was significantly higher in patients with U urealyticum positivity (15.9% vs 36.4%; P < .01). However, multivariate logistic regression analysis failed to reveal a significant association between the presence of U urealyticum and BPD development (odds ratio: 2.4 [95% confidence interval: 0.9-6.3]; P = .06). Clarithromycin treatment resulted in eradication of U urealyticum in 68.5% of the patients. The incidence of BPD was significantly lower in the clarithromycin group than in the placebo group (2.9% vs 36.4%; P < .001). Multivariate logistic regression analysis confirmed the independent preventive effect of clarithromycin for the development of BPD (odds ratio: 27.2 [95% confidence interval: 2.5-296.1]; P = .007). CONCLUSIONS:Clarithromycin treatment prevents development of BPD in preterm infants who are born at 750 to 1250 g and colonized with U urealyticum.
Authors: Rose M Viscardi; Ahmed A Othman; Hazem E Hassan; Natalie D Eddington; Elias Abebe; Michael L Terrin; David A Kaufman; Ken B Waites Journal: Antimicrob Agents Chemother Date: 2013-02-25 Impact factor: 5.191
Authors: L Marcela Merchan; Hazem E Hassan; Michael L Terrin; Ken B Waites; David A Kaufman; Namasivayam Ambalavanan; Pamela Donohue; Susan J Dulkerian; Robert Schelonka; Laurence S Magder; Sagar Shukla; Natalie D Eddington; Rose M Viscardi Journal: Antimicrob Agents Chemother Date: 2014-11-10 Impact factor: 5.191
Authors: Malene Plejdrup Hansen; Anna M Scott; Amanda McCullough; Sarah Thorning; Jeffrey K Aronson; Elaine M Beller; Paul P Glasziou; Tammy C Hoffmann; Justin Clark; Chris B Del Mar Journal: Cochrane Database Syst Rev Date: 2019-01-18
Authors: Georg Hansmann; Angeles Fernandez-Gonzalez; Muhammad Aslam; Sally H Vitali; Thomas Martin; S Alex Mitsialis; Stella Kourembanas Journal: Pulm Circ Date: 2012 Apr-Jun Impact factor: 3.017