Pediatric

Clarithromycin in Preventing Bronchopulmonary Dysplasia in Ureaplasma urealyticum −Positive Preterm Infants Ramazan Ozdemir, Omer Erdeve, Evrim Alyamac Dizdar, Serife Suna Oguz, Nurdan Uras, Sibel Saygan, Erdem Karabulut and Ugur Dilmen Pediatrics 2011;128;e1496; originally published online November 28, 2011; DOI: 10.1542/peds.2011-1350

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PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, ElkGrove Village, Illinois, 60007. Copyright © 2011 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.

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Clarithromycin in Preventing Bronchopulmonary Dysplasia in Ureaplasma urealyticum–Positive Preterm Infants
WHAT’S KNOWN ON THIS SUBJECT: Despitenumerous studies, controversy still exists about whether Ureaplasma urealyticum colonization or infection of the respiratory tract contributes to the development of bronchopulmonary dysplasia. Additional controversy exists on the use of macrolides for the treatment of U urealyticum. WHAT THIS STUDY ADDS: Clarithromycin treatment prevents development of bronchopulmonary dysplasia in preterminfants who are born at 750 to 1250 g and colonized with U urealyticum.
AUTHORS: Ramazan Ozdemir, MD,a Omer Erdeve, MD,a Evrim Alyamac Dizdar, MD,a Serife Suna Oguz, MD,a Nurdan Uras, MD,a Sibel Saygan, MD,b Erdem Karabulut, PhD,c and Ugur Dilmen, MDa
aNeonatal Intensive Care Unit and bDepartment of Microbiology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey; and cDepartment ofBiostatistics, Hacettepe University, Ankara, Turkey

KEY WORDS bronchopulmonary dysplasia, clarithromycin, premature infants, Ureaplasma urealyticum ABBREVIATIONS BPD—bronchopulmonary dysplasia OR—odds ratio CI—confidence interval RDS—respiratory distress syndrome PDA—patent ductus arteriosus This trial has been registered at www.clinicaltrials.gov (identifier NCT01326611).www.pediatrics.org/cgi/doi/10.1542/peds.2011-1350 doi:10.1542/peds.2011-1350 Accepted for publication Aug 15, 2011 Address correspondence to Ramazan Ozdemir, MD, Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, 06110 Hamamonu, Ankara, Turkey. E-mail: ramazanoz@ yahoo.com.tr PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Copyright © 2011 by the American Academy of PediatricsFINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

abstract
OBJECTIVE: To evaluate the efficacy and safety of clarithromycin treatment in preventing bronchopulmonary dysplasia (BPD) in Ureaplasma urealyticum–positive preterm infants. PATIENTS AND METHODS: Nasopharyngeal swabs for U urealyticum culture were taken from infantswith 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 hada 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)....