Author’s conclusions: azithromycin (AZT), when administered prophylactically, is associated with a decrease of bronchopulmonary dysplasia (BPD) and in the composite variable DBP / mortality in preterm infants (RNP). This effect disappeared by including other macrolides in the analysis. Because the pharmacokinetics of these drugs in RNP is not well known and because of its possible adverse effects, more studies are needed before recommending the routine use of AZT in RNP.
Reviewers’ comments: AZT, administered prophylactically, has a modest effectiveness in reducing the incidence of BPD. There are no available data on the safety of AZT in preterm or on what subset of RNP would benefit most from this intervention. In view of the currently available evidence it seems prudent not to use this drug systematically in RNP.