Evidence map›Paper›PMID 38739754›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024

Assessment of Spillover of Antimicrobial Resistance to Untreated Children 7-12 Years Old After Mass Drug Administration of Azithromycin for Child Survival in Niger: A Secondary Analysis of the MORDOR Cluster-Randomized Trial.

Brittany Peterson, Ahmed M Arzika, Abdou Amza, Ramatou Maliki, Alio Mankara Karamba, Mariama Moussa, Mariama Kemago, Zijun Liu, Eric Houpt, Jie Liu and 6 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Trial
  4. Article
  5. Institutional spillover effects of antimicrobial use on antimicrobial resistance andAntimicrobial stewardship & healthcare epidemiology : ASHE · 2026
    Article
  6. Review
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

16 authors.

Brittany PetersonFrancis I. Proctor Foundation, University of California, San Francisco, California, USA.ORCID 0009-0008-8815-1642
Ahmed M ArzikaCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Abdou AmzaProgramme Nationale de Santé Oculaire, Niamey, Niger.
Ramatou MalikiCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Alio Mankara KarambaCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Mariama MoussaCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Mariama KemagoCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Zijun LiuFrancis I. Proctor Foundation, University of California, San Francisco, California, USA.
Eric HouptDivision of Infectious Diseases & International Health, University of Virginia, Charlottesville, Virginia, USA.
Jie LiuSchool of Public Health, Qingdao University, Qingdao, China.
Suporn PholwatDivision of Infectious Diseases & International Health, University of Virginia, Charlottesville, Virginia, USA.
Thuy DoanFrancis I. Proctor Foundation, University of California, San Francisco, California, USA.
Travis C PorcoFrancis I. Proctor Foundation, University of California, San Francisco, California, USA.
Jeremy D KeenanFrancis I. Proctor Foundation, University of California, San Francisco, California, USA.
Thomas M LietmanFrancis I. Proctor Foundation, University of California, San Francisco, California, USA.
Kieran S O'BrienFrancis I. Proctor Foundation, University of California, San Francisco, California, USA.ORCID 0000-0002-1962-5321

Funding

Résistance Evaluée contre la Vie des Enfants au Niger-Implementation et Recherche (REVENIR). Community antimicrobial resistance after azithromycin distribution: selection, spillover, co-selectionR01AI175250 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI THOMAS M LIETMAN, Kieran O'Brien · 2024 to 2026
$2.3M
Gates Foundation OP1032340National Institute of Allergy and Infectious Disease R01AI175250NIAID NIH HHS R01 AI175250NIH HHS
6 · The paper itself

Abstract

backgroundThe risk of antibiotic resistance is complicated by the potential for spillover effects from one treated population to another. Azithromycin mass drug administration programs report higher rates of antibiotic resistance among treatment arms in targeted groups. This study aimed to understand the risk of spillover of antibiotic resistance to nontarget groups in these programs.

methodsData were used from a cluster-randomized trial comparing the effects of biannual azithromycin and placebo distribution to children 1-59 months old on child mortality rates. Nasopharyngeal samples from untreated children 7-12 years old were tested for genetic determinants of macrolide resistance (primary outcome) and resistance to other antibiotic classes (secondary outcomes). Linear regression was used to compare the community-level mean difference in prevalence by arm at the 24-month time point, adjusting for baseline prevalence.

resultsA total of 1103 children 7-12 years old in 30 communities were included in the analysis (15 azithromycin, 15 placebo). The adjusted mean differences in the prevalence of resistance determinants for macrolides, β-lactams, and tetracyclines were 3.4% (95% confidence interval, -4.1% to 10.8%; P = .37), -1.2% (-7.9% to 5.5%; P = .72), and -3.3% (-9.5% to 2.8%; P = .61), respectively.

conclusionsWe were unable to demonstrate a statistically significant increase in macrolide resistance determinants in untreated groups in an azithromycin mass drug administration program. While the result might be consistent with a small spillover effect, this study was not powered to detect such a small difference. Larger studies are warranted to better quantify the potential for spillover effects within these programs.

Indexed as

Anti-Bacterial AgentsAzithromycinDrug Resistance, BacterialMass Drug AdministrationChildChild MortalityChild, PreschoolFemaleHumansInfantMacrolidesMaleNasopharynxNigerAnti-Bacterial AgentsAzithromycinMacrolidesantimicrobial resistanceazithromycinmass drug administrationNigerspillover

Identifiers

PMID38739754
PMCPMC11581702

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.