Long-term Impact of Oral Azithromycin taken by Gambian women during Labour on Prevalence and Antibiotic Susceptibility of S. pneumoniae and S. aureus in their Infants: Follow up of a Randomized Clinical Trial.


Bojang, A; Camara, B; Jagne Cox, I; Oluwalana, C; Lette, K; Usuf, E; Bottomley, C; Howden, BP; D'Alessandro, U; Roca, A; (2018) Long-term Impact of Oral Azithromycin taken by Gambian women during Labour on Prevalence and Antibiotic Susceptibility of S. pneumoniae and S. aureus in their Infants: Follow up of a Randomized Clinical Trial. Clinical infectious diseases. ISSN 1058-4838 DOI: https://doi.org/10.1093/cid/ciy254

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Abstract

Oral azithromycin given to women in labour decreases maternal and neonatal bacterial carriage but increases azithromycin resistant bacteria during at least 4 weeks following the intervention. We assessed the prevalence of bacterial carriage and azithromycin resistance 12 months after treatment among study infants. Nasopharyngeal swabs (NPS) were collected between November 2014 and May 2015 from children 11-13 months old whose mothers had received azithromycin or placebo during labour. S. pneumoniae and S. aureus were isolated using conventional microbiological methods. Antibiotic susceptibility was determined by disc diffusion and confirmed by E-test or VITEK 2. NPS were collected from 461 children. The prevalence of S. pneumoniae and S. aureus was similar between children from the azithromycin and placebo arms [85.0% vs. 82.1% OR=1.23 95%CI (0.73-2.08) for S. pneumoniae and 21.7% vs. 21.3% OR=1.02 95%CI (0.64-1.63) for S. aureus]. Prevalence of azithromycin-resistant S. pneumoniae was similar in both arms [1.8% vs. 0.9% in children from the azithromycin and placebo arms respectively, OR=2.10 95%CI (0.30-23.38)]; resistance to other antibiotics was also similar between arms. For S. aureus, there was no differences in azithromycin resistance between children in the azithromycin (3.1%) and placebo (2.6%) arms; OR=1.22 95%CI (0.35-4.47) or resistance to any other antibiotics. The higher prevalence of S. aureus azithromycin resistance observed among women treated during labour and their babies four weeks after treatment had waned 12 months after delivery. Azithromycin intervention did not induce other antibiotic resistance to S. pneumoniae or S. aureus. ClinicalTrials.gov Identifier NCT01800942.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Disease Control
PubMed ID: 29608659
URI: http://researchonline.lshtm.ac.uk/id/eprint/4647218

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