Data from: The impact of long-term azithromycin on antibiotic resistance in HIV-associated chronic lung disease
External Organisations University of Cape Town; Biomedical Research and Training Institute Harare; London School of Hygiene and Tropical Medicine; Malawi-Liverpool-Wellcome Trust Clinical Research Programme; University College London; UiT The Arctic University of Norway Associated Persons Regina Esi...
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The University of Western Australia
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Online Access: | https://researchdata.edu.au/data-from-the-lung-disease/1822458 https://doi.org/10.5061/dryad.5dv41ns71 |
Summary: | External Organisations University of Cape Town; Biomedical Research and Training Institute Harare; London School of Hygiene and Tropical Medicine; Malawi-Liverpool-Wellcome Trust Clinical Research Programme; University College London; UiT The Arctic University of Norway Associated Persons Regina Esinam Abotsi (Creator); Grace McHugh (Creator); Victoria Simms (Creator); Andrea M. Rehman (Creator); Charmaine Barthus (Creator); Lucky Gift Ngwira (Creator); Brenda Anna Kwambana-Adams (Creator); Robert S Heyderman (Creator); Jon Ø Odland (Creator); Rashida A Ferrand (Creator); Felix S. Dube (Creator) Background: Selection for resistance to azithromycin (AZM) and other antibiotics such as tetracyclines and lincosamides remains a concern with long-term AZM use for treatment of chronic lung diseases (CLD). We investigated the impact of 48 weeks of AZM on the carriage and antibiotic resistance of common respiratory bacteria among children with HIV-associated CLD. Methods: Nasopharyngeal (NP) swabs and sputa were collected at baseline, 48 and 72 weeks from participants with HIV-associated CLD randomised to receive weekly AZM or placebo for 48 weeks and followed post-intervention until 72 weeks. The primary outcomes were prevalence and antibiotic resistance of Streptococcus pneumoniae (SP), Staphylococcus aureus (SA), Haemophilus influenzae (HI), and Moraxella catarrhalis (MC) at these timepoints. Mixed-effects logistic regression and Fisher's exact test were used to compare carriage and resistance respectively. Results: Of 347 (174 AZM, 173 placebo) participants (median age 15 years [IQR =13–18], females 49%),NP carriage was significantly lower in the AZM (n=159) compared to placebo (n=153) arm for SP (18% vs 41%, p<0.001), HI (7% vs 16%, p=0.01), and MC (4% vs 11%, p=0.02); SP resistance to AZM (62% [18/29] vs 13%[8/63], p<0.0001) or tetracycline (60%[18/29] vs 21%[13/63], p<0.0001) were higher in the AZM arm. Carriage of SA resistant to AZM (91% [31/34] vs 3% [1/31], p<0.0001), tetracycline (35% [12/34] ... |
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