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Does azithromycin given to women in labour decrease ocular bacterial infection in neonates? A double-blind, randomized trial
BACKGROUND: Vertical transmission can result in neonatal infection and disease. Reducing the transmission of bacterial pathogens from mother to infant may be an effective means of preventing neonatal infection, including bacterial conjunctivitis. METHODS: In a double-blind, randomized trial, we asse...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5746019/ https://www.ncbi.nlm.nih.gov/pubmed/29282015 http://dx.doi.org/10.1186/s12879-017-2909-4 |
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author | Burr, Sarah E. Camara, Bully Oluwalana, Claire Bojang, Ebrima Bottomley, Christian Bojang, Abdoulie Bailey, Robin L. D’Alessandro, Umberto Roca, Anna |
author_facet | Burr, Sarah E. Camara, Bully Oluwalana, Claire Bojang, Ebrima Bottomley, Christian Bojang, Abdoulie Bailey, Robin L. D’Alessandro, Umberto Roca, Anna |
author_sort | Burr, Sarah E. |
collection | PubMed |
description | BACKGROUND: Vertical transmission can result in neonatal infection and disease. Reducing the transmission of bacterial pathogens from mother to infant may be an effective means of preventing neonatal infection, including bacterial conjunctivitis. METHODS: In a double-blind, randomized trial, we assessed the effect of administering a single dose of oral azithromycin to women in labour on bacterial colonization of the neonate. A reduction in purulent neonatal conjunctivitis was a secondary objective of the trial. Ocular samples were collected from the lower fornix of infants presenting with clinical signs of purulent conjunctivitis during the first eight weeks of life. Incidence of purulent conjunctivitis was compared between trial arms. Bacterial infection was assessed using PCR and incidence of purulent conjunctivitis due to bacteria was also compared between arms. RESULTS: Forty of 843 infants (4.7%) presented clinical signs of purulent conjunctivitis. No significant difference in incidence of purulent conjunctivitis was seen between azithromycin and placebo arms [4.3% (18/419) versus 5.2% (22/424), OR = 0.82, 95% CI (0.44,1.54), p = 0.628]. S. aureus was the most commonly identified pathogen, detected in 38% of cases. Incidence of purulent-conjunctivitis due to bacterial infection was lower in the azithromycin arm [1.2% (5/419) versus 3.8% (16/424), OR = 0.31, 95% CI (0.12–0.82), p = 0.025)]. The incidence of gram-positive bacteria was also lower in the azithromycin arm [1.0% (4/419) versus 3.3% (14/424), OR = 0.28, 95%CI (0.10–0.82), p = 0.029]. CONCLUSIONS: Oral azithromycin given to women during labour may have the potential to reduce the incidence of bacterial neonatal conjunctivitis. TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT01800942, registration date 26 Feb 2013. |
format | Online Article Text |
id | pubmed-5746019 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-57460192018-01-03 Does azithromycin given to women in labour decrease ocular bacterial infection in neonates? A double-blind, randomized trial Burr, Sarah E. Camara, Bully Oluwalana, Claire Bojang, Ebrima Bottomley, Christian Bojang, Abdoulie Bailey, Robin L. D’Alessandro, Umberto Roca, Anna BMC Infect Dis Research Article BACKGROUND: Vertical transmission can result in neonatal infection and disease. Reducing the transmission of bacterial pathogens from mother to infant may be an effective means of preventing neonatal infection, including bacterial conjunctivitis. METHODS: In a double-blind, randomized trial, we assessed the effect of administering a single dose of oral azithromycin to women in labour on bacterial colonization of the neonate. A reduction in purulent neonatal conjunctivitis was a secondary objective of the trial. Ocular samples were collected from the lower fornix of infants presenting with clinical signs of purulent conjunctivitis during the first eight weeks of life. Incidence of purulent conjunctivitis was compared between trial arms. Bacterial infection was assessed using PCR and incidence of purulent conjunctivitis due to bacteria was also compared between arms. RESULTS: Forty of 843 infants (4.7%) presented clinical signs of purulent conjunctivitis. No significant difference in incidence of purulent conjunctivitis was seen between azithromycin and placebo arms [4.3% (18/419) versus 5.2% (22/424), OR = 0.82, 95% CI (0.44,1.54), p = 0.628]. S. aureus was the most commonly identified pathogen, detected in 38% of cases. Incidence of purulent-conjunctivitis due to bacterial infection was lower in the azithromycin arm [1.2% (5/419) versus 3.8% (16/424), OR = 0.31, 95% CI (0.12–0.82), p = 0.025)]. The incidence of gram-positive bacteria was also lower in the azithromycin arm [1.0% (4/419) versus 3.3% (14/424), OR = 0.28, 95%CI (0.10–0.82), p = 0.029]. CONCLUSIONS: Oral azithromycin given to women during labour may have the potential to reduce the incidence of bacterial neonatal conjunctivitis. TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT01800942, registration date 26 Feb 2013. BioMed Central 2017-12-28 /pmc/articles/PMC5746019/ /pubmed/29282015 http://dx.doi.org/10.1186/s12879-017-2909-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Burr, Sarah E. Camara, Bully Oluwalana, Claire Bojang, Ebrima Bottomley, Christian Bojang, Abdoulie Bailey, Robin L. D’Alessandro, Umberto Roca, Anna Does azithromycin given to women in labour decrease ocular bacterial infection in neonates? A double-blind, randomized trial |
title | Does azithromycin given to women in labour decrease ocular bacterial infection in neonates? A double-blind, randomized trial |
title_full | Does azithromycin given to women in labour decrease ocular bacterial infection in neonates? A double-blind, randomized trial |
title_fullStr | Does azithromycin given to women in labour decrease ocular bacterial infection in neonates? A double-blind, randomized trial |
title_full_unstemmed | Does azithromycin given to women in labour decrease ocular bacterial infection in neonates? A double-blind, randomized trial |
title_short | Does azithromycin given to women in labour decrease ocular bacterial infection in neonates? A double-blind, randomized trial |
title_sort | does azithromycin given to women in labour decrease ocular bacterial infection in neonates? a double-blind, randomized trial |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5746019/ https://www.ncbi.nlm.nih.gov/pubmed/29282015 http://dx.doi.org/10.1186/s12879-017-2909-4 |
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