A new study finds that the use of azithromycin may hold promise in treating Ureaplasma-colonized or infected premature infants to prevent bronchopulmonary dysplasia (BPD). The University of Kentucky study, published in Pediatric Pulmonology, showed subjects colonized or infected with the Ureaplasma bacteria developed BPD or died 73% of the time in the azithromycin-treated group, compared to 94% of the time in the placebo group.

The presence of the Ureaplasma bacterium is a risk factor in developing BPD. This bacterium causes inflammation in the lungs and can also lead to meningitis, pneumonia, or septicemia. It is passed on from mother to child. An estimated 80% of women are already colonized with it, and nearly 45% of extremely preterm infants are affected by it.

“Current preventative therapies for bronchopulmonary dysplasia are limited,” said Hubert O. Ballard, MD, a neonatologist and lead author of the study. “Because the inflammation from a Ureaplasma infection often leads to BPD, and because this bacterium is so easily spread to infants from the mother, we sought to find out if the anti-inflammatory benefits of azithromycin could help prevent the disorder from developing.”

The study was performed on a group of 220 infants admitted to the UK neonatal intensive care unit from September 2004 to August 2008. Enrollment criteria included a birth weight less than 1,250 grams, the use of intermittent mechanical ventilation for fewer than 12 hours, and an age of under 72 hours.

Upon enrollment, each infant was randomized to receive azithromycin or a placebo for a total of six weeks. Infants testing positive for Ureaplasma were placed in a separate subgroup of the study.

The researcher previously published a pilot study that demonstrated a possible benefit of azithromycin prophylaxis in infants weighing less than 1,000 grams, but the original study excluded patients who tested positive for the Ureaplasma bacteria.

Neither the previous study nor the current study demonstrated a statistically significant benefit to using azithromycin therapy to prevent BPD in preterm infants who were not colonized or infected with Ureaplasma.

Though the results of the current study show potential for preventing BPD in Ureaplasma-colonized or infected patients, Ballard stressed that a larger multicentered trial is needed to properly assess the benefits of azithromycin for these subjects.

Source: University of Kentucky