Effect of Azithromycin in Addition to Inhaled Corticosteroids in Severe Preschool Wheeze: A Retrospective Cohort Study.

INTRODUCTION

Preschool wheeze is common, and treatment options are limited, consisting mainly of inhaled corticosteroids (ICS). We report here a retrospective study in severe preschool wheezers not controlled by high doses of ICS, who were given azithromycin as long-term additional therapy.

METHODS

We conducted a single-center, retrospective study between 2020 and 2025, including children less than 6 years old with severe recurrent wheeze, partially or uncontrolled despite a high dose of ICS and who were given azithromycin three times a week for 6 months as maintenance treatment.

RESULTS

Thirty-eight children with a mean age of 2.3 ± 1.2 years were retrospectively included in our center. We found an improvement in the control of wheezing and a decrease of exacerbations, daily respiratory symptoms, and dose of daily ICS after 6 months of azithromycin treatment, without major secondary effect declared.

CONCLUSION

Azithromycin could therefore be considered as an adjunctive treatment in young children with persistent asthma and frequent exacerbations despite high doses of inhaled steroids. This conclusion is from a retrospective study, and it is needed to perform controlled prospective studies to validate these findings.