ReviewFrontiers in pediatrics2026
Efficacy and safety of azithromycin in preventing bronchopulmonary dysplasia in preterm infants: a systematic review and meta-analysis.
Review in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
Introduction: Ureaplasma colonization in preterm infants is linked to pulmonary inflammation and bronchopulmonary dysplasia (BPD). Evidence regarding the effectiveness of macrolides, including their prophylactic role in preventing BPD, remains limited. This review aimed to assess whether azithromycin reduces the incidence of BPD or death in preterm infants, with or without Ureaplasma colonization, compared with placebo or no intervention. Methods: We followed PRISMA guidelines and searched PubMed, Cochrane Library, Embase, and Google Scholar for randomized controlled trials (RCTs) evaluating azithromycin in preterm infants with unknown or confirmed Ureaplasma infection. Primary outcomes were death and BPD, while secondary outcomes included hospital stay, adverse events, and ventilation or oxygen duration. Studies not focused on preterm infants, lacking Ureaplasma status, or not randomized were excluded. Results: A meta-analysis of six randomized controlled trials, including 1,446 preterm infants with unknown or confirmed Ureaplasma status and sample sizes ranging from 80 to 796, compared azithromycin with placebo. No significant reduction was observed in BPD incidence [risk ratio (RR) = 0.92, 95% CI: 0.78-1.09, Conclusion: This systematic review and meta-analysis evaluated azithromycin efficacy and safety in preventing BPD and reducing mortality in preterm infants. No significant reduction in BPD or mortality was observed with azithromycin compared with placebo. Secondary outcomes, including ventilation duration, supplemental oxygen use, and hospitalization length, showed no improvement. However, heterogeneity among secondary outcomes was moderate to high, and included studies were limited. Systematic Review Registration: PROSPERO CRD42024572847.
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