Azithromycin Use in Treating Pediatric Respiratory Infections

Assessing Effectiveness and Antibiotic Resistance Trends

Abstract

Introduction: Pediatric respiratory tract infections are among the leading causes of morbidity and antibiotic use worldwide. Azithromycin is frequently prescribed due to its broad-spectrum activity and favorable dosing schedule. However, rising concerns about antibiotic resistance necessitate a critical assessment of its clinical effectiveness and emerging resistance patterns.

Methodology: This prospective observational study was conducted at the Department of Pediatrics, Lady Reading Hospital (LRH), Peshawar, over a 12-month period from January 2023 to December 2023. A total of 154 pediatric patients diagnosed with respiratory tract infections and treated with azithromycin were included. Clinical outcomes were recorded, and bacterial cultures were obtained in selected cases for sensitivity testing. Statistical analysis included descriptive statistics, chi-square tests, t-tests, and logistic regression to assess associations between resistance and clinical variables.

Results: Out of 154 patients, 126 (81.8%) showed complete clinical recovery within 5–7 days of azithromycin therapy. Resistance to azithromycin was found in 32 out of 114 tested samples (28.1%), with Streptococcus pneumoniae showing the highest resistance at 36.4%, followed by Haemophilus influenzae at 31.8%. Treatment failure occurred in 18.2% of patients, with significantly higher rates in those infected with resistant pathogens (p < 0.01). Fever duration was also prolonged in resistant cases (mean 5.2 days vs. 3.6 days; p < 0.001).

Conclusion: Azithromycin remains effective in treating pediatric respiratory infections; however, the emergence of resistant bacterial strains significantly compromises clinical outcomes. Routine culture and sensitivity testing, along with antimicrobial stewardship, are essential to sustain its utility in pediatric practice.