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To the Editor The study by Dr Bacharier and colleagues1 found that using azithromycin in preschool children with a history of wheezing and respiratory tract infection (RTI) prevented progression to “severe” lower respiratory tract illness (LRTI). The authors defined severe LRTI as needing intensive rescue albuterol treatments; it was not defined as pneumonia, the classic definition of severe LRTI. Although azithromycin limited the need for intensive rescue albuterol, it did not prevent urgent care or emergency visits, hospitalizations, or future RTI episodes, arguably the most important prevention outcomes.
Fleming-Dutra KE, Friedman CR, Hicks LA. Early Azithromycin Treatment to Prevent Severe Lower Respiratory Tract Illnesses in Children. JAMA. 2016;315(19):2121–2122. doi:10.1001/jama.2016.0918
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