Chang Eugenie, Ballard Kaci E, Johnson Peter N, Nandyal Raja, Miller Jamie L
Department of Pharmacy: Clinical and Administrative Sciences (EC, KEB, PNJ, JLM), University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma.
Section of Neonatology (RN), Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
J Pediatr Pharmacol Ther. 2023;28(1):10-19. doi: 10.5863/1551-6776-28.1.10. Epub 2023 Feb 3.
Azithromycin has been explored as a treatment option for eradication of and prevention of bronchopulmonary dysplasia (BPD) in preterm neonates. However, there is debate about the need for eradication of and whether azithromycin is safe and efficacious for this indication. This literature review provides an overview of the evidence for use of azithromycin for eradication of and prevention of BPD, including dosing and duration of azithromycin used in these studies. The literature search included articles published in the English language in Medline and PubMed from 1946 to January 2022. Relevant citations within identified articles were also reviewed. A total of 9 studies representing 388 neonates were included. The percentage of neonates that tested positive for in these studies ranged from 18.6% to 57.1%. Azithromycin was initiated at <3 days of life in 8 studies (88.9%). Dosing was variable and ranged from 5 to 20 mg/kg/dose administered once daily, and the duration of treatment ranged from 1 to 35 days. Most studies used intravenous azithromycin. Overall, azithromycin was more efficacious than placebo at eradication; however, most of these studies did not find a difference in the incidence of BPD between patients receiving azithromycin versus placebo. No adverse effects, specifically pyloric stenosis or QT interval prolongation, were noted in these studies.
阿奇霉素已被探索作为根除和预防早产儿支气管肺发育不良（BPD）的一种治疗选择。然而，对于是否需要根除以及阿奇霉素用于该适应症是否安全有效存在争议。这篇文献综述概述了使用阿奇霉素根除和预防BPD的证据，包括这些研究中使用的阿奇霉素剂量和疗程。文献检索包括1946年至2022年1月在Medline和PubMed上发表的英文文章。对已识别文章中的相关引用也进行了审查。总共纳入了9项研究，涉及388名新生儿。这些研究中检测呈阳性的新生儿百分比在18.6%至57.1%之间。8项研究（88.9%）在出生后<3天开始使用阿奇霉素。剂量各不相同，每日一次给药剂量为5至20mg/kg，治疗疗程为1至35天。大多数研究使用静脉注射阿奇霉素。总体而言，在根除方面阿奇霉素比安慰剂更有效；然而，这些研究中的大多数未发现接受阿奇霉素治疗的患者与接受安慰剂治疗的患者在BPD发生率上存在差异。这些研究中未观察到不良反应，特别是幽门狭窄或QT间期延长。
