Efficacy of oral amoxicillin–clavulanate or azithromycin for non-severe respiratory exacerbations in children with bronchiectasis (BEST-1): a multicentre, three-arm, double-blind, randomised placebo-controlled trial

Publication date: Available online 16 August 2019Source: The Lancet Respiratory MedicineAuthor(s): Vikas Goyal, Keith Grimwood, Robert S Ware, Catherine A Byrnes, Peter S Morris, I Brent Masters, Gabrielle B McCallum, Michael J Binks, Heidi Smith-Vaughan, Kerry-Ann F O'Grady, Anita Champion, Helen M Buntain, André Schultz, Mark Chatfield, Paul J Torzillo, Anne B ChangSummaryBackgroundBronchiectasis guidelines recommend antibiotics for the treatment of acute respiratory exacerbations, but randomised placebo-controlled trials in children are lacking. We hypothesised that oral amoxicillin–clavulanate and azithromycin would each be superior to placebo in achieving symptom resolution of non-severe exacerbations in children by day 14 of treatment.MethodsIn this multicentre, three-arm, parallel, double-dummy, double-blind, randomised placebo-controlled trial at four paediatric centres in Australia and New Zealand, we enrolled children aged 1–18 years with CT-confirmed bronchiectasis unrelated to cystic fibrosis, who were under the care of a respiratory physician and who had had at least two respiratory exacerbations in the 18 months before study entry. Participants were allocated (1:1:1) at exacerbation onset to receive oral suspensions of amoxicillin–clavulanate (45 mg/kg per day) plus placebo azithromycin, azithromycin (5 mg/kg per day) plus placebo amoxicillin–clavulanate, or both placebos for 14 days. An independent statistician prepared a computer-generated, permuted-b...
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research