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December 2017

Macrolides and Pediatric Community-Acquired Pneumonia—Time for a Paradigm Shift?

Author Affiliations
  • 1Division of Pediatric Infectious Diseases, Duke University, Durham, North Carolina
JAMA Pediatr. 2017;171(12):1147-1148. doi:10.1001/jamapediatrics.2017.3828

Azithromycin is one of the most commonly used antibiotics in pediatrics. It was prescribed to 12.2 million outpatients in 2013, accounting for almost 20% of all antibiotic prescriptions for children in the ambulatory setting.1 Much of this use is inappropriate either because a more narrow-spectrum agent would suffice or because antibiotics are not needed at all. One of the few pediatric indications for macrolides is community-acquired pneumonia (CAP); nearly one-third of hospitalized children admitted to freestanding children’s hospitals with CAP are treated with a macrolide.2 Although this is standard of care, the study by Williams and colleagues3 in this issue of JAMA Pediatrics questions the necessity of this practice.3

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