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Use and Safety of Azithromycin in Neonates: A Systematic Review

Coral Smith, Oluwaseun Egunsola, Imti Choonara, Sailesh Kotecha, Evelyne Jacqz-Aigrain, Helen Sammons

BMJ Open. 2015 Dec 9;5(12):e008194.

PMID: 26656010

Abstract:

Objectives:
To identify the use and adverse drug reactions associated with azithromycin in neonates.
Setting:
Databases MEDLINE (1948-August 2015), EMBASE (1980-August 2015) and Pubmed (August 2015) were searched for studies on azithromycin in neonates.
Participants:
All studies involving neonates (<28 days old) who have received at least a single dose of azithromycin for which safety was evaluated.
Primary and secondary outcome measures:
The primary outcome was adverse event (AE) associated with use of azithromycin. Use of azithromycin in neonates was the secondary outcome.
Results:
A total of 11 articles involving 473 neonates were identified. 371 AEs were reported. Adverse events were mainly respiratory (358/1000 neonate), neurological (273/1000 neonates) and gastrointestinal (196/1000 neonates) in origin. Azithromycin significantly reduced the risk of bronchopulmonary dysplasia (BPD) in extremely premature neonates (RR=0.83, 95% CI 0.71 to 0.98, p=0.02). There was no significant difference in the incidence of elevated liver enzymes between the azithromycin and placebo group (p=0.76). There were four cases of infantile hypertrophic pyloric stenosis (IHPS).
Conclusions:
Azithromycin significantly reduces the risk of BPD in preterm neonates. The relationship between azithromycin and IHPS requires further investigation.

Chemicals Related in the Paper:

Catalog Number Product Name Structure CAS Number Price
AP83905015-A Azithromycin Azithromycin 83905-01-5 Price
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