Evidence map›Paper›PMID 42078412›Full record

ArticlemedRxiv : the preprint server for health sciences2026

Impact of Azithromycin Administration at Hospital Discharge on Antimicrobial Resistance and Enteropathogen Carriage 3 Months Following Treatment.

Polycarp Mogeni, John Benjamin Ochieng, Kevin Kariuki, Doreen Rwigi, Hannah E Atlas, Kirkby D Tickell, Laura Riziki Aluoch, Catherine Sonye, Evans Apondi, Lilian Ambila and 10 more

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

20 authors.

Polycarp MogeniCenter for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
John Benjamin OchiengCenter for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
Kevin KariukiCenter for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Doreen RwigiCenter for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Hannah E AtlasDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Kirkby D TickellDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID 0000-0002-4108-1236
Laura Riziki AluochCenter for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
Catherine SonyeCenter for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
Evans ApondiCenter for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
Lilian AmbilaCenter for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
Mame M DiakhateDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Benson O SingaDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Jie LiuSchool of Public Health, Qingdao University, Qingdao, China.
James A Platts-MillsDivision of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
Queen SaidiDivision of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
Donna M DennoDepartment of Pediatrics, University of Washington, Seattle, Washington, United States of America.
Ferric C FangDepartment of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, United States of America.
Judd L WalsonThe Childhood Acute Illness & Nutrition (CHAIN) Network, Nairobi, Kenya.
Eric R HouptDivision of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
Patricia B PavlinacDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID 0000-0002-0051-9131

Funding

Mechanisms of post-discharge morbidity and mortality in HIV-infected and HIV-exposed uninfected childrenR01HD079695 · NICHD · UNIVERSITY OF WASHINGTON · PI WALSON, JUDD L. · 2015 to 2019
$3.8M
The role of enteric pathogens and antimicrobial resistance in driving clinical and nutritional deterioration, and azithromycin's potential effect, among children discharged from hospital in KenyaR01AI150978 · NIAID · UNIVERSITY OF WASHINGTON · PI PAVLINAC, PATRICIA · 2020 to 2024
$3.7M
NIAID NIH HHS R01 AI150978NICHD NIH HHS R01 HD079695
6 · The paper itself

Abstract

Background: The Toto Bora trial tested whether a course of azithromycin reduced rates of re-hospitalization or death in the 6 months following hospitalization among Kenyan children. We hypothesized that azithromycin would reduce enteric bacteria and increase carriage of macrolide resistance in the subsequent 3 months. Methods: Kenyan children (1-59 months) hospitalized and subsequently discharged for non-traumatic conditions provided fecal samples before and 3 months after randomization to a 5-day course of azithromycin or placebo. Quantitative PCR identified enteropathogens and AMR-conferring genes in fecal samples. Generalized estimating equations assessed the impact of the randomization arm on pathogen and resistance gene detection, accounting for baseline presence and site. Results: Among 1,393 baseline stools, 12.4% had at least one bacterial enteropathogen, 94.7% had at least one macrolide-resistance gene, and 92.6% had at least one beta-lactamase-resistance gene identified. At month 3, children randomized to azithromycin had a 6.1% higher likelihood of carrying a macrolide resistance gene compared to placebo (adjusted prevalence ratio [aPR], 1.06; 95% Cl, 1.04-1.08; PcO.OOl). Specifically, azithromycin randomization was associated with a higher relative prevalence of Interpretation: Azithromycin at hospital discharge was associated with higher carriage of macrolide-resistance-conferring genes in the post-discharge period compared with placebo, without significant declines in enteric pathogen carriage other than modest changes to

Indexed as

AMRazithromycinenteric pathogensmacrolide resistancepost-discharge

Identifiers

PMID42078412
PMCPMC13131741

What OpenQuestion holds

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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.