{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T07:14:46Z","timestamp":1793776486866,"version":"4.6.1"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bronchopulmonary dysplasia (BPD), a chronic lung disease in preterm infants, often leads to acute respiratory exacerbations triggered by infections. Our previous mouse study suggested that azithromycin's anti\u2010inflammatory properties may benefit virus\u2010induced respiratory illnesses prophylactically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this single\u2010center, double\u2010blind RCT, 60 children (6 months to 6 years) with BPD received azithromycin (5\u2009mg\/kg three times weekly;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930) or placebo (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930) for one winter season (October to March). Primary outcome was the total number of days of unscheduled healthcare clinic visits, ER visits, and hospital days. Secondary outcomes comprised clinic visits, ER visits, hospital admissions, hospital days, and adverse events. Standard frequentist and Bayesian analyses were used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant difference in primary outcomes, unscheduled healthcare visits (macrolides 14.9 vs. 4.2 per child\u2010year;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.1, IRR\u2009=\u20092.1; 95% CI: 0.8\u22125.4), Bayesian analysis showing 11% probability of benefit; however, high\u2010risk children (&lt;\u20092 years, no tracheostomy), rates were lower with the macrolide group (2.7 vs. 4.6 per child\u2010year; IRR\u2009=\u20090.6; 95% CI: 0.2\u20131.5), with an 82% probability of benefit. Two outliers in the macrolide group stayed\u2009&gt;\u200940 days in the hospital for non\u2010medical reasons. For secondary outcomes, we observe a decrease in the intervention group on ER visits (0.5 vs. 1.3 per child\u2010year;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047, IRR\u2009=\u20090.4; 95% CI: 0.1\u22120.9). Hospital days increased (12.1 vs. 1.2 per child\u2010year; IRR\u2009=\u20099.3; 95% CI: 5.5\u221216.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Macrolide prophylaxis did not lead to a significant reduction in the primary outcome of unscheduled healthcare encounter days, but subgroup analysis suggests a potential benefit in high\u2010risk children, with 82% probability of benefit.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      NCT02544984.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71314","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T19:23:12Z","timestamp":1760556192000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effect of Chronic Azithromycin Use in Winter on Health Care Utilization for Children With Bronchopulmonary Dysplasia: A Double Blind Randomized Controlled Study (RCT)"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5350-331X","authenticated-orcid":false,"given":"Ricardo A.","family":"Mosquera","sequence":"first","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School, Division of Pediatric Pulmonology The University of Texas Health Science Center at Houston (UTHealth Houston) Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravind","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School, Division of Pediatric Pulmonology The University of Texas Health Science Center at Houston (UTHealth Houston) Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Del Mar","family":"Romero\u2010Lopez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School, Division of Neonatal\u2010Perinatal Medicine UTHealth Houston Houston Texas USA"},{"name":"Institute for Clinical Research and Learning Health Care, McGovern Medical School UTHealth Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan G.","family":"Magana\u2010Ceballos","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School, Division of Pediatric Pulmonology The University of Texas Health Science Center at Houston (UTHealth Houston) Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Shahrukh","family":"Hashmi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School UTHealth Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfredo","family":"De Jesus Rojas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Puerto Rico School of Medicine San Juan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Tellez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School UTHealth Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaleigh","family":"Riggs\u2010Harpur","sequence":"additional","affiliation":[{"name":"Pediatric Research Center University of Texas Health Sciences in Houston  Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima M.","family":"Boricha","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School UTHealth Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina S.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School UTHealth Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice L.","family":"John","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School UTHealth Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomika S.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School UTHealth Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2560-6693","authenticated-orcid":false,"given":"Carlos 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