The Effect Of Azithromycin On The Treatment Of First Wheezing Children And The Influence Of Recurrent Wheezing

Objective:To investigate the therapeutic effect of azithromycin on children with wheezing for the first time and the effect of recurrent wheezing,so as to provide certain guiding significance for the clinical treatment and prevention of asthmatic diseases.Methods:From December 2020 to July 2021,105 children who were admitted to the Pediatrics Department of the Affiliated Hospital of North Sichuan Medical College due to the first wheezing diagnosis of bronchiolitis,asthmatic bronchitis or asthmatic pneumonia were collected,4 cases were excluded,and 101 cases were included.Randomly divided into experimental group(53 cases)and control group(48 cases)when they were admitted to hospital.The control group was given conventional treatment measures such as relieving cough and relieving asthma.The experimental group was given intravenous infusion of azithromycin 5-10 mg/kg/d on the basis of the control group for 3-5 days.Clinical data were recorded,followed up by telephone for re-wheezing and readmission at 3 and 6 months after discharge,and the treatment effect,re-wheezing and readmission risk of the two groups were compared and analyzed.Results:The mean age of 101 children with first wheezing was 7.53±4.95 months,and most of them were male,with a male to female ratio of 1.7:1;33 cases(32.7%)were positive for respiratory tract 6,and 16 cases were respiratory syncytial virus.The sputum culture results were positive in 49 cases(48.5%),most of which were Haemophilus influenzae(35.1%),Moraxella catarrh(23.4%)and Streptococcus pneumoniae(22.1%);The relief time of cough and wheeze in the experimental group was shorter than that in the control group(P<0.05);There was no significant difference in discharge time between the two groups(P>0.05);The re-wheezing rate in the experimental group within 3 months after discharge was lower than that in the control group(P<0.05),and the re-wheezing rate within 3 months after discharge in the control group was 1.732 times higher than that in the experimental group(95%CI:1.013-2.961).There was no significant difference in the re-wheezing rate within 6 months after discharge between the two groups(P>0.05).The re-wheezing rate of patients with eczema history in the experimental group was lower than that in the control group within 3 months after discharge(P<0.05),and there was no significant difference in the re-wheezing rate between the two groups within 6 months(P>0.05).There was no significant difference in rehospitalization rate between the two groups in 3 and 6 months.Conclusions:1.Azithromycin can shorten the relief time of wheezing and cough in children with first wheezing,but can not shorten the length of hospital stay;2.Azithromycin can reduce the incidence of first wheezing in children with eczema from 0 to 3 months after discharge.