Azithromycin to Prevent Post-discharge Morbidity and Mortality in Kenyan Children
Status:
Completed
Trial end date:
2020-05-04
Target enrollment:
Participant gender:
Summary
Children hospitalized with severe illness in sub-Saharan Africa are at high risk of morbidity
and mortality following discharge from hospital. These children represent an accessible
high-risk population in which targeted interventions to prevent morbidity and mortality could
have dramatic impact. A large cluster randomized trial of azithromycin delivered in a mass
drug administration program within trachoma endemic areas in sub-Saharan Africa demonstrated
an almost 50% mortality benefit in children 1-9 years of age in treated communities. However,
mass drug administration of azithromycin leads to the rapid emergence of macrolide resistance
within treated communities and is expensive. The targeted delivery of azithromycin to
children at hospital discharge may be a novel and practical intervention to maximize benefit
while minimizing risk of antibiotic resistance. This is a randomized, double-blind,
placebo-controlled trial to determine the efficacy of azithromycin provided at discharge,
compared to placebo, in reducing mortality and re-hospitalization rates in children age 1-59
months in Kenya. The study will also investigate potential mechanisms by which azithromycin
may reduce morbidity and mortality in this population and will assess the emergence of
antibiotic resistance among treated individuals and their primary caregivers. A
cost-effectiveness analysis of the intervention will also be conducted.
Phase:
Phase 4
Details
Lead Sponsor:
University of Washington
Collaborators:
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Kenya Medical Research Institute