Gut Resistome of Preschool Children After Prolonged Mass Azithromycin Distribution: A Cluster-randomized Trial

Clin Infect Dis. 2021 Oct 5;73(7):1292-1295. doi: 10.1093/cid/ciab485.


We evaluated the gut resistome of children from communities treated with 10 twice-yearly azithromycin distributions. Although the macrolide resistance remained higher in the azithromycin arm, the selection of non-macrolide resistance observed at earlier time points did not persist. Longitudinal resistance monitoring should be a critical component of mass distribution programs.

Clinical trials registration: NCT02047981.

Keywords: Niger; antibiotic resistance; azithromycin; gut resistome; mass drug distribution; preschool children.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents* / therapeutic use
  • Azithromycin* / pharmacology
  • Child, Preschool
  • Drug Resistance, Bacterial / genetics
  • Humans
  • Macrolides / pharmacology
  • Mass Drug Administration


  • Anti-Bacterial Agents
  • Macrolides
  • Azithromycin

Associated data