Abstract
Background: Ureaplasma respiratory tract infection (RTI) is a risk factor for BPD, but its effects on later pulmonary outcomes are unknown. We hypothesized that preterms with Ureaplasma RTI in the first week of life would have more severe respiratory morbidity (RM)(≥2 hospitalization or ER visits for respiratory illnesses, systemic steroids use, home oxygen>3 mo, or cough/wheeze despite inhaled steroid Rx) at 12 mo AA than non-infected infants and that AZM eradication of Ureaplasma RTI would reduce RM in the first year of life.
Objective: To determine the potential of AZM to reduce severe RM at 12 mo AA.
Methods: Infants 240-286 wk GA enrolled in a prospective, multicenter, double-blind, placebo-controlled RCT were randomized to either AZM 20 mg/kg IV (N=60) or equal volume of D5W (placebo)(N=61) q24hx3d and tracheal(TA)/nasopharyngeal(NP) samples were obtained pre- and post-dosing for Ureaplasma culture and PCR. Pulmonary questionnaires were completed at 6 and 12 mo AA. Data were analyzed by Chi-Square, Wilcoxon, or Kruskal Wallis Test.
Results: 44/121(36.3%) were Ureaplasma+. Questionnaires for 105(95%)(6 mo) and 91(82%)(12 mo) AA survivors have been completed to date. TA(+) infants had lower survival [15(71%)] and BPD‑free survival [7(33%] than TA(-) infants [47(90%) & 26(50%)] and NP specimens only infants [48(100%) & 37(79%)], respectively (p<0.01 each). The frequency of death or severe RM at 12 mo AA was lower in AZM‑treated [3/9 (33%)] than in placebo‑treated TA+ infants [6/7(86%)](p=0.036).
Conclusion(s): TA+Ureaplasma RTI is associated with greater adverse outcomes and AZM may improve survival and reduce severe RM in this high-risk group.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, OA301.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018