From the Guidelines
Azithromycin is not recommended as prophylaxis against salmonella lymphadenitis in children with congenital Interleukin (IL) deficiency based on the provided evidence. The evidence provided does not support the use of azithromycin for this specific indication. Instead, the guidelines recommend the use of other antibiotics such as TMP-SMZ, ampicillin, cefotaxime, ceftriaxone, or chloramphenicol for the prevention of salmonella infections in immunocompromised individuals 1.
Key Points to Consider
- The guidelines provided are focused on the prevention of opportunistic infections in persons infected with HIV, and do not specifically address the use of azithromycin for prophylaxis against salmonella lymphadenitis in children with congenital IL deficiency.
- The recommended antibiotics for the prevention of salmonella infections in immunocompromised individuals do not include azithromycin 1.
- Azithromycin may be effective against salmonella species, but its use as prophylaxis for this specific indication is not supported by the provided evidence.
- Regular monitoring for side effects and counseling on food safety practices are important considerations for the management of immunocompromised individuals, but are not directly related to the use of azithromycin as prophylaxis against salmonella lymphadenitis.
Clinical Implications
- Clinicians should follow established guidelines for the prevention of opportunistic infections in immunocompromised individuals, and consider the use of recommended antibiotics for the prevention of salmonella infections.
- The use of azithromycin as prophylaxis against salmonella lymphadenitis in children with congenital IL deficiency should be approached with caution, and only considered in consultation with a specialist and based on individual patient needs.
From the Research
Azithromycin as Prophylaxis against Salmonella Lymphadenitis
- The use of azithromycin as prophylaxis against salmonella lymphadenitis in children with congenital Interleukin (IL) deficiency is not directly addressed in the provided studies.
- However, studies have shown that azithromycin is effective against Salmonella infections, including typhoid fever 2, 3.
- Azithromycin has been shown to be effective in treating uncomplicated typhoid fever in children and adolescents, with a cure rate of 94% 3.
- The susceptibility of Salmonella isolates to azithromycin has been studied, and most isolates have been found to be susceptible, with MICs ≤16mg/L 4.
- In a study of experimental Salmonella typhimurium infection in mice, azithromycin was found to be as effective as ciprofloxacin in reducing mortality and splenic viable counts 2.
Considerations for IL Deficiency
- Children with congenital IL deficiency, such as IL-12Rβ1 deficiency, are at increased risk of recurrent salmonellosis 5.
- The use of azithromycin as prophylaxis in these patients may be considered, given its efficacy against Salmonella infections.
- However, the optimal dosage and duration of azithromycin prophylaxis in this population are not established, and further studies are needed to determine its effectiveness and safety 6, 5, 4, 2, 3.