title: Clarithromycin in preventing bronchopulmonary dysplasia in Ureaplasma urealyticum-positive preterm infants.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of clarithromycin treatment in preventing bronchopulmonary dysplasia (BPD) in Ureaplasma urealyticum-positive preterm infants.
  
  
  METHODS
  Nasopharyngeal swabs for U urealyticum culture were taken from infants with a birth weight between 750 and 1250 g in the first 3 postnatal days. Infants with a positive culture for U urealyticum were randomly assigned to 1 of 2 groups to receive either intravenous clarithromycin or placebo. All the patients were followed at least up to the 36th postmenstrual week.
  
  
  RESULTS
  A total of 224 infants met the eligibility criteria of the study. Seventy-four (33%) infants had a positive culture for U urealyticum in the first 3 day cultures. The rate of BPD development was significantly higher in patients with U urealyticum positivity (15.9% vs 36.4%; P < .01). However, multivariate logistic regression analysis failed to reveal a significant association between the presence of U urealyticum and BPD development (odds ratio: 2.4 [95% confidence interval: 0.9-6.3]; P = .06). Clarithromycin treatment resulted in eradication of U urealyticum in 68.5% of the patients. The incidence of BPD was significantly lower in the clarithromycin group than in the placebo group (2.9% vs 36.4%; P < .001). Multivariate logistic regression analysis confirmed the independent preventive effect of clarithromycin for the development of BPD (odds ratio: 27.2 [95% confidence interval: 2.5-296.1]; P = .007).
  
  
  CONCLUSIONS
  Clarithromycin treatment prevents development of BPD in preterm infants who are born at 750 to 1250 g and colonized with U urealyticum.
authors: Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey. ramazanoz@yahoo.com.tr
authors: Ramazan
authors: R
authors: Ozdemir
authors: Omer
authors: O
authors: Erdeve
authors: Evrim Alyamac
authors: EA
authors: Dizdar
authors: Serife Suna
authors: SS
authors: Oguz
authors: Nurdan
authors: N
authors: Uras
authors: Sibel
authors: S
authors: Saygan
authors: Erdem
authors: E
authors: Karabulut
authors: Ugur
authors: U
authors: Dilmen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001997:Bronchopulmonary Dysplasia / Q000209:etiology* / Q000517:prevention & control*; D017291:Clarithromycin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies; D016869:Ureaplasma Infections / Q000150:complications* / Q000188:drug therapy*; D016990:Ureaplasma urealyticum
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin