Single dose azithromycin to prevent cholera in children

单剂量阿奇霉素预防儿童霍乱

• 批准号: 10462780
• 负责人: JASON B HARRIS
• 金额: $ 57.36万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-05 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10462780
• 关键词: Address; Advisory Committees; Age; Antibiotic Prophylaxis; Antibiotic Resistance; Antibiotic Therapy; Antibiotics; Antimicrobial Resistance; Area; Azithromycin; Bacteria; Bacterial Antibiotic Resistance; Bangladesh; Case Study; Cessation of life; Chemoprophylaxis; Child; Cholera; Cholera Vaccine; Clinical; Cluster randomized trial; Data; Dehydration; Detection; Development; Diarrhea; Disease; Dose; Education; Enrollment; Environment; Epidemic; Feces; Future; Goals; Hour; Household; Hygiene; IV Fluid; Infection; Intervention; Knowledge; Measures; Metagenomics; Molecular; Monitor; Only Child; Oral; Outcome; Participant; Patient Self-Report; Patients; Placebos; Prevention; Prevention strategy; Prophylactic treatment; Prospective Studies; Public Health Practice; Randomized; Research; Research Design; Risk; Sanitation; Severities; Site; Symptoms; Testing; Time; Vaccines; Variant; Vibrio cholerae; Vibrio cholerae O1; Vibrio cholerae infection; Visit; Vomiting; Water; World Health Organization; Yemen; antigen test; base; clinical care; clinical practice; cooking; effectiveness measure; effectiveness testing; group intervention; gut bacteria; high risk; improved; indexing; infection risk; intervention effect; liquid chromatography mass spectroscopy; member; mortality; placebo group; post intervention; prevent; prophylactic; prospective; rapid diagnosis; standard of care; transmission process

PROJECT SUMMARY Vibrio cholerae causes 3 million cases of cholera and 100,000 deaths annually. Young children are most vulnerable to cholera, yet they are not protected by current vaccines. More aggressive approaches are needed to prevent the cholera, especially in young children. To meet this challenge, the World Health Organization has targeted the elimination of the global threat of cholera transmission by the year 2030, but the strategic approach to achieve this ambitious goal has not yet been determined. For patients with cholera, effective antibiotic treatment dramatically reduces the severity of infection and prevents the release of trillions of V. cholerae bacteria into the environment. However, while antibiotics are often effectively used to prevent other infections, there are no standards for the use of antibiotics to prevent cholera. As a result, there is tremendous variation in practice, and antibiotics with unproven efficacy are frequently given to prevent cholera. These unproven approaches may needlessly contribute to antibiotic resistance in both V. cholerae and important bystander bacteria as well. For this reason, the World Health Organization Task Force on Cholera Control has recommended a halt to widespread antibiotic use for preventing cholera, and instead recommends that studies be done to test the effectiveness of antibiotics for cholera prevention as well as their impact of this on antimicrobial resistance. Our proposal addresses this exact knowledge gap. We will determine whether single-dose azithromycin is effective in preventing V. cholerae infection in children who live in a household where there has been a case of cholera. Without intervention, these children have a 30% chance of developing infection within one week. While a single-dose of azithromycin is a preferred treatment for cholera, azithromycin to prevent cholera has never been studied. Azithromycin has been found to be beneficial in other mass prevention studies in children, but the impact of single-dose of azithromycin on antibiotic resistance has not been sufficiently tested. We anticipate that this study will result in the more effective and judicious use of antibiotics to prevent cholera in children.

项目摘要 弧菌霍乱每年造成300万例霍乱和100,000例死亡。年幼的孩子最 容易受到霍乱的影响，但它们不受当前疫苗的保护。需要更积极的方法 为了防止霍乱，尤其是在幼儿中。为了应对这一挑战，世界卫生组织有 针对2030年消除霍乱传播的全球威胁，但战略 实现这一雄心勃勃的目标的方法尚未确定。 对于霍乱患者，有效的抗生素治疗大大降低了感染的严重程度 防止将数万亿杆菌细菌释放到环境中。但是，抗生素是 通常有效地用于防止其他感染，没有使用抗生素的标准来防止 霍乱。结果，实践存在巨大差异，并且疗效未经证实的抗生素是 经常给予防止霍乱。这些未经证实的方法可能不必要地有助于抗生素 V.霍乱和重要旁观者细菌的抗性。因此，世界健康 霍乱控制的组织工作队建议停止使用广泛的抗生素使用 防止霍乱，而建议进行研究以测试抗生素的有效性 霍乱预防以及它们对抗菌耐药性的影响。 我们的建议解决了这个确切的知识差距。我们将确定单剂量阿奇霉素是否是 有效防止住在有一个案例的家庭中的儿童中 霍乱。如果没有干预，这些孩子就有30％的机会在一周内发展感染。 虽然单剂量的阿奇霉素是霍乱的首选治疗方法，但阿奇霉素可预防霍乱 从未被研究过。已经发现阿奇霉素在儿童的其他大规模预防研究中是有益的， 但是，单剂量的阿奇霉素对抗生素耐药性的影响尚未得到充分测试。我们 预计这项研究将导致对抗生素的更有效，更明智地防止霍乱 孩子们。