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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...

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Autores principales: Burr, Sarah E., Camara, Bully, Oluwalana, Claire, Bojang, Ebrima, Bottomley, Christian, Bojang, Abdoulie, Bailey, Robin L., D’Alessandro, Umberto, Roca, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
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.
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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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