Evidence map›Paper›PMID 28771627›Full record

Trial reportPloS one2017

Treatment of preschool children presenting to the emergency department with wheeze with azithromycin: A placebo-controlled randomized trial.

Piush J Mandhane, Patricia Paredes Zambrano de Silbernagel, Yin Nwe Aung, Janie Williamson, Bonita E Lee, Sheldon Spier, Mary Noseworthy, William R Craig, David W Johnson

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 6 pooled it
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 6 syntheses or guidelines pooled it, 47 citations in OpenAlex.

  1. Macrolides versus placebo for chronic asthma.The Cochrane database of systematic reviews · 2021
    Pooled it
  2. Pooled it
  3. Pooled it
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  5. Pooled it
  6. Pooled it
  7. Trial
  8. Azithromycin administered for acute bronchiolitis may have a protective effect on subsequent wheezing.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
    Trial
  9. Asthma Phenotypes and Biomarkers.Respiratory care · 2025
    Review
  10. Article
  11. Review
  12. Diagnosis and management of asthma in infants and preschoolers.Clinical and experimental pediatrics · 2022
    Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Exacerbation-Prone Asthma.The journal of allergy and clinical immunology. In practice · 2020
    Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Piush J MandhaneDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Patricia Paredes Zambrano de SilbernagelDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.ORCID http://orcid.org/0000-0002-0248-8869
Yin Nwe AungDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Janie WilliamsonDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Bonita E LeeDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Sheldon SpierDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Mary NoseworthyDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
William R CraigDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
David W JohnsonDepartments of Pediatrics, Emergency Medicine and Physiology and Pharmacology, Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
University of Alberta · CAUniversity of Calgary · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntibiotics are frequently used to treat wheezing children. Macrolides may be effective in treating bronchiolitis and asthma.

methodWe completed a prospective, double-blinded, randomized placebo-control trial of azithromycin among pre-school children (12 to 60 months of age) presenting to the emergency department with wheeze. Patients were randomized to receive either five days of azithromycin or placebo. Primary outcome was time to resolution of respiratory symptoms after treatment initiation. Secondary outcomes included the number of days children used a Short-Acting Beta-Agonists during the 21 day follow-up and time to disease exacerbation during the following six months (unscheduled health care visit or treatment with an oral corticosteroid for acute respiratory symptoms).

resultsOf the 300 wheezing children recruited, 222 and 169 were analyzed for the primary and secondary outcomes, respectively. The treatment groups had similar demographics and clinical parameters at baseline. Median time to resolution of respiratory symptoms was four days for both treatment arms (interquartile range (IQR) 3,6; p = 0.28). Median number of days of Short-Acting Beta-Agonist use among those who received azithromycin was four and a half days (IQR 2, 7) and five days (IQR 2, 9; p = 0.22) among those who received placebo. Participants who received azithromycin had a 0.91 hazard ratio for time to six-month exacerbation compared to placebo (95% CI 0.61, 1.36, p = 0.65). A pre-determined subgroup analysis showed no differences in outcomes for children with their first or repeat episode of wheezing. There was no significant difference in the proportion of participants experiencing an adverse event.

conclusionAzithromycin neither reduced duration of respiratory symptoms nor time to respiratory exacerbation in the following six months after treatment among wheezing preschool children presenting to an emergency department. There was no significant effect among children with either first-time or prior wheezing.

Indexed as

Anti-Bacterial AgentsAsthmaAzithromycinChild, PreschoolDisease ProgressionDouble-Blind MethodEmergency Service, HospitalFemaleHumansInfantMalePrognosisProspective StudiesRespiratory SoundsSurvival RateAnti-Bacterial AgentsAzithromycin

Identifiers

PMID28771627
PMCPMC5542589
OpenAlexW2744763475

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.