University of Cape Town
Department of Molecular and Cell Biology,
Regina Esinam Abotsi is a L'Oréal-UNESCO For Women in Science and Organisation of Women in Science for the Developing World PhD Fellow at the Department of Molecular and Cell Biology, University of Cape Town. Her previous research on the molecular mechanisms underlying an emerging fluoroquinolone resistance in Haemophilus species isolated from private sector patients in Durban earned her a master of Pharmaceutical Microbiology degree from the University of KwaZulu-Natal, South Africa in 2016. During her masters she participated in two desktop analyses on antimicrobial resistance in the WHO AFRO and EMRO regions leading to a publication (Perspectives Antimicrobial resistance in the WHO African region: current status and roadmap for action) and a report. She obtained her Bachelor of Pharmacy degree from the Kwame Nkrumah University of Science and Technology, Ghana in 2012. Ms Abotsi is a registered pharmacist in Ghana and also an Assistant Lecturer at the University of Health and Allied Science, Ghana. Her current research focuses on the effect of long-term azithromycin therapy on the respiratory microbiota of African children with HIV-associated chronic lung disease and the skin microbiota of children with atopic dermatitis. Her other research interests are molecular epidemiology of antibiotic resistance, antibiotic stewardship policy formulation and implementation by developing countries.

Presenter Of 1 Presentation

IMPACT OF LONG-TERM AZITHROMYCIN THERAPY ON CARRIAGE AND ANTIBIOTIC RESISTANCE OF RESPIRATORY BACTERIA AMONG CHILDREN WITH HIV-ASSOCIATED CHRONIC LUNG DISEASE: A RANDOMISED CONTROLLED TRIAL

Session Type
Oral Presentations
Date
Thu, 24.02.2022
Session Time
10:00 AM - 11:00 AM
Room
Sala E
Session Icon
Pre-Recorded with Live Q&A
Lecture Time
10:40 AM - 10:50 AM

Abstract

Background

Selection for antibiotic resistance remains a concern with long-term azithromycin (AZM) use in chronic lung diseases (CLD).

Aims

We investigated the impact of 48 weeks of AZM on the carriage and antibiotic resistance of common respiratory bacteria among children with HIV-associated CLD.

Methods

Nasopharyngeal (NP) swabs and sputa were collected at baseline, 48 and 72 weeks from participants with HIV-associated CLD randomised to receive weekly AZM or placebo for 48 weeks and followed post-intervention until 72 weeks. The primary outcomes were prevalence and antibiotic resistance of Streptococcus pneumoniae (SP), Staphylococcus aureus (SA), Haemophilus influenzae (HI), and Moraxella catarrhalis (MC) at these timepoints. Mixed-effects logistic regression and Fisher's exact test were used to compare carriage and resistance respectively.

Results

Of 347 (174 AZM, 173 placebo) participants (median age 15 years [IQR =13–18], females 49%),NP carriage was significantly lower in the AZM (n=159) compared to placebo (n=153) arm for SP (18% vs 41%, p<0.001), HI (7% vs 16%, p=0.01), and MC (4% vs 11%, p=0.02); SP resistance to AZM (62% [18/29] vs 13%[8/63], p<0.0001) or tetracycline (60%[18/29] vs 21%[13/63], p<0.0001) were higher in the AZM arm. Carriage of SA resistant to AZM (91% [31/34] vs 3% [1/31], p<0.0001), tetracycline (35% [12/34] vs 13% [4/31], p= 0.05) and clindamycin (79% [27/34] vs 3% [1/31], p<0.0001) was also significantly higher in the AZM arm and persisted at 72 weeks. Similar findings were observed for sputa.

Conclusions

The risk of drug resistance should be considered during long-term AZM use. The clinical significance of antibiotic resistance needs investigation.

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