Trial reportThe Lancet. Microbe2022
Prevalence of nasopharyngeal
Trial report in The Lancet. Microbe, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Efficacy and safety of traditional Chinese medicine combined with azithromycin sequential therapy forFrontiers in pharmacology · 2024Pooled it
- Costs, Coverage, and Acceptability of Azithromycin Mass Administration to Children 1-11 Versus 1-59 Months Old to Reduce Mortality: A Cluster-Randomized Trial in Niger.The American journal of tropical medicine and hygiene · 2025Trial
- The Impact of Antenatal Azithromycin and Monthly Sulfadoxine-Pyrimethamine on Maternal Malaria during Pregnancy and Fetal Growth: A Randomized Controlled Trial.The American journal of tropical medicine and hygiene · 2023Trial
- Effect of Biannual Azithromycin to Children under 5 Years on the Carriage of Respiratory Pathogens among Children Aged 7-11 Years.The American journal of tropical medicine and hygiene · 2023Trial
- Genomic epidemiology and antimicrobial resistance profile ofMicrobial genomics · 2026Article
- Modelling impacts of paediatric amoxicillin shortage management on pneumococcal resistance and invasive disease in Europe.Nature communications · 2026Article
- Azithromycin mass drug administration to reduce childhood mortality in humanitarian crises.PLOS global public health · 2026Review
- Community-level Monitoring of Antimicrobial Resistance following Mass Administration of Azithromycin to Reduce Child Mortality in Côte d'Ivoire: Results from Two Rounds of Surveillance.Gates open research · 2026Article
- Comparison of antimicrobial resistance genes on the ocular surface of patients with corneal infections in California and Malawi.International health · 2025Article
- Mass drug administration trials of azithromycin: an analysis to inform future research and guidelines.Infectious diseases of poverty · 2025Review
- Article
- Antibiotic utilization patterns in Tanzania: a retrospective longitudinal study comparing pre- and intra-COVID-19 pandemic era using Tanzania Medicines and Medical Devices Authority data.JAC-antimicrobial resistance · 2024Article
- Trends inOpen forum infectious diseases · 2023Article
- An Overview of Macrolide Resistance in Streptococci: Prevalence, Mobile Elements and Dynamics.Microorganisms · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAzithromycin mass drug administration (MDA) could reduce child mortality. However, macrolide resistance, which has generally been reported to develop after whole-community MDA for trachoma control, is a concern, and it has less commonly been studied in the context of treating children to reduce mortality. Here, we report on macrolide resistance after biannual azithromycin MDA at the Malawi site of the MORDOR study.
methodsIn the MORDOR cluster-randomised trial in Malawi, 30 communities in Mangochi District were randomly selected. Communities were randomly assigned to receive azithromycin or placebo by simple randomisation without stratification. Children aged 1-59 months were administered azithromycin 20 mg/kg or placebo as an oral suspension biannually for a total of four treatments in 2015-17. 1200 children (40 children per community) were randomly selected for nasopharyngeal swabs at baseline, 12 months (6 months after the second treatment visit), and 24 months (6 months after the fourth treatment visit). Samples were processed to culture
findingsAt baseline, 3467 (76%) of 4541 eligible children in the azithromycin group and 3107 (72%) of 4308 eligible children in the placebo group were treated. 564 nasopharyngeal swabs were taken from the azithromycin group and 563 from the placebo group, with similar numbers of swabs taken at 12 months and 24 months. In both groups at baseline, carriage of
interpretationThese findings support previous evidence from trachoma MDA programmes and suggest that monitoring of macrolide resistance should remain a key component of azithromycin interventions for reducing child mortality.
fundingBill & Melinda Gates Foundation.
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Registered trials
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.