Active Ingredients: Azithromycin
Human Research Ethics Committees at all participating institutions approved the study and caregivers provided written, informed consent. Randomization, allocation and blinding, and medications An independent statistician used a computer-generated, permuted block design to generate randomization sequences.
Sealed opaque envelopes selecting one of the eight different bottle codes concealed the treatment allocation. Neither the study team researchers, hospital staff nor parents were aware of assigned treatment groups until data analysis was completed.
Study nurses contacted families via mobile phones to help ensure adherence 20. Clinical assessment, management, and outcomes Demographic, medical history, and clinical data were recorded on standardized data collection forms.
A validated severity score was employed see Supplementary Material. The protocol was in place for several months before commencing the trial.
Infants received additional therapies other than macrolides at the discretion of the treating pediatrician. The primary endpoints of LOS for respiratory illness and duration of oxygen requirement where applicable were monitored every 12 h.
For the other clinical outcomes, the day-21 review was conducted by study nurses urban-based participants and local health clinic staff remote-based.
Respiratory rehospitalization within 6 months of discharge was recorded through community and hospital electronic records.
Adverse events were monitored daily in hospital by research staff and following discharge with weekly phone calls until the day-21 review. NPS were cultured for respiratory bacterial pathogens that also underwent antibiotic susceptibility testing 24.
Data were analyzed according to our published protocol.
This test is necessary because some bacteria express a phenotype known as MLSB, in which susceptibility tests will indicate the bacteria are susceptible to clindamycin, but in vitro the pathogen displays inducible resistance.
If the area of inhibition around the clindamycin disk is "D" shaped, the test result is positive and clindamycin should not be used due to the possibility of resistant pathogens and therapy failure.
If the area of inhibition around the clindamycin disk is circular, the test result is negative and clindamycin can be used. It was a feast for the eyes and nose.
An Orange Tree in the hothouse in the walled garden Tibouchina — Glory Bush in the hothouse Elsewhere on the Island there are Horsetail Ferns emerging in damp and soggy places, looking more like miniature Triffids than any plant you can readily identify.
Bluebell leaves are pushing through in woods and Primroses wink from sheltered nooks and crannies wherever they have managed to gain a foothold. Horsetail Ferns Primroses — wherever they can gain a foothold Bluebell leaves pushing their way through the moss Dog Violets in the woods Wood Anemone emerging Winter flowering Aconite Even the birds have changed their songs to a more melodious version of their usual repertoire, especially when the sun shines and the day warms up as it did last weekend.
Robins sang heartily, Chaffinches proclaimed their new spring plumage and even the Eagles called relentlessly as they climbed and drifted and played on the thermals.