FRIDAY, May 22, 2026 (HealthDay News) -- For preschool-aged children presenting to the emergency department with moderate-to-severe acute wheezing, azithromycin does not lead to a reduction in the severity of wheezing-related symptoms, according to a study published online May 18 in the New England Journal of Medicine.
Kurt R. Denninghoff, M.D., from the University of Arizona in Tucson, and colleagues randomly assigned patients aged 18 to 59 months who presented to an emergency department with a moderate-to-severe episode of wheezing to receive azithromycin once daily (12 mg/kg body weight) or matching placebo for five days. The sum of scores on the Asthma Flare-up Diary for Young Children (ADYC) over five days was assessed as the primary outcome.
Overall, 521 of the 840 patients who were randomly assigned tested positive for pathogenic bacteria. After a planned interim analysis, the trial was stopped for futility. The researchers observed no significant difference in ADYC scores between the azithromycin and placebo groups in either the positive cohort or the negative cohort. In the positive cohort, bacterial clearance was 58.7 and 11.4 percent in the azithromycin and placebo groups, respectively. For both cohorts, the two groups had similar secondary outcomes, development of bacterial resistance, and incidence of adverse events.
"The fact that the children with the pathogenic bacteria didn't respond to the antibiotic -- even if we eradicated the bacteria -- challenges the idea that bacteria cause the wheezing," lead author Fernando D. Martinez, M.D., also from the University of Arizona, said in a statement. "The bacteria are probably there because the children have a susceptibility."
Two authors disclosed ties to the biopharmaceutical and medical technology industries.
