Impact of recent antibiotics on nasopharyngeal carriage and lower airway infection in Indigenous Australian children with non-cystic fibrosis bronchiectasis

Hare, K. M., Leach, A. J., Morris, P. S., Smith-Vaughan, H., Torzillo, P., Bauert, P., Cheng, A. C., McDonald, M. I., Brown, N., Chang, A. B. and Grimwood, K. (2012) Impact of recent antibiotics on nasopharyngeal carriage and lower airway infection in Indigenous Australian children with non-cystic fibrosis bronchiectasis. International Journal of Antimicrobial Agents, 40 4: 365-369. doi:10.1016/j.ijantimicag.2012.05.018


Author Hare, K. M.
Leach, A. J.
Morris, P. S.
Smith-Vaughan, H.
Torzillo, P.
Bauert, P.
Cheng, A. C.
McDonald, M. I.
Brown, N.
Chang, A. B.
Grimwood, K.
Title Impact of recent antibiotics on nasopharyngeal carriage and lower airway infection in Indigenous Australian children with non-cystic fibrosis bronchiectasis
Journal name International Journal of Antimicrobial Agents   Check publisher's open access policy
ISSN 0924-8579
1872-7913
Publication date 2012-10
Sub-type Article (original research)
DOI 10.1016/j.ijantimicag.2012.05.018
Open Access Status
Volume 40
Issue 4
Start page 365
End page 369
Total pages 5
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Indigenous Australian children have increased rates of bronchiectasis. Despite a lack of high-level evidence on effectiveness and antibiotic resistance, these children often receive long-term antibiotics. In this study, we determined the impact of recent macrolide (primarily azithromycin) and β-lactam antibiotic use on nasopharyngeal colonisation, lower airway infection (>104 CFU/mL of bronchoalveolar lavage fluid culture) and antibiotic resistance in non-typeable Haemophilus influenzae (NTHi), Streptococcus pneumoniae and Moraxella catarrhalis isolates from 104 Indigenous children with radiographically confirmed bronchiectasis. Recent antibiotic use was associated with significantly reduced nasopharyngeal carriage, especially of S. pneumoniae in 39 children who received macrolides [odds ratio (OR) = 0.22, 95% confidence interval (CI) 0.08–0.63] and 26 children who received β-lactams (OR = 0.07, 95% CI 0.01–0.32), but had no significant effect on lower airway infection involving any of the three pathogens. Children given macrolides were significantly more likely to carry (OR = 4.58, 95% CI 1.14–21.7) and be infected by (OR = 8.13, 95% CI 1.47–81.3) azithromycin-resistant S. pneumoniae. Children who received β-lactam antibiotics may be more likely to have lower airway infection with β-lactamase-positive ampicillin-resistant NTHi (OR = 4.40, 95% CI 0.85–23.9). The risk of lower airway infection by antibiotic-resistant pathogens in children receiving antibiotics is of concern. Clinical trials to determine the overall benefit of long-term antibiotic therapy are underway.
Keyword Azithromycin
Bronchiectasis
Microbial drug resistance
Nasopharynx
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published under Short communication

Document type: Journal Article
Sub-type: Article (original research)
Collections: Faculty of Health and Behavioural Sciences -- Publications
Official 2013 Collection
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 9 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 9 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Mon, 10 Sep 2012, 11:12:35 EST by Roxanne Jemison on behalf of Child Health Research Centre