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Author: Admin | 2025-04-28
Exposure to azithromycin in the first 2 weeks of life (adjusted OR [aOR] of 8.26, 95% CI 2.62–26.0) [43]. Azithromycin exposure between 15 and 42 days also increased the risk of IHPS (aOR of 2.98, 95% CI 1.24–7.20).Subgroup analysis of dosageThe incidence of diarrhea, vomiting, fever, and rash was higher in the high-dosage group compared with the low- or medium-dosage group (P 5). The incidence of prolonged QT and increased eosinophils was higher in the medium-dosage group than in the low-dosage group (P 5).Table 5 Pooled incidence of ADRs from RCTs and prospective cohort studies in different dose groupsFull size tableDiscussionOur review found that the main toxicity of azithromycin in pediatrics was gastrointestinal toxicity, specifically diarrhea, vomiting, and abdominal pain. Based on available data, the main ADRs of azithromycin as MDA were diarrhea and vomiting. However, the reporting of ADRs in RCTs of MDA was very variable. Concerns about the reporting of ADRs in RCTs involving children have been reported by several groups [44, 45]. For azithromycin not as MDA, our review highlighted that the most common toxicity was GI adverse reactions, and the most serious toxicities were cardiac adverse reactions and IHPS. The risk of cardiac toxicity and IHPS following MDA is unknown and can only be determined by prospective surveillance studies. The dose of azithromycin was associated with the risk of ADRs. The higher the dosage, the higher the risk of an ADR.Our study has several strengths. Using rigorous systematic review methods, we did a comprehensive search of
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