Efficacy of oral amoxicillin–clavulanate or azithromycin for non-severe respiratory exacerbations in children with bronchiectasis (BEST-1): a multicentre, three-arm, double-blind, randomised placebo-controlled trial -

Efficacy of oral amoxicillin–clavulanate or azithromycin for non-severe respiratory exacerbations in children with bronchiectasis (BEST-1): a multicentre, three-arm, double-blind, randomised placebo-controlled trial
Information type: Randomised controlled trials
Source: The Lancet Respiratory Medicine
Specialities: Infection and infectious diseases | Paediatric and neonatal medicine | Respiratory disorders
Summary
RCT (n=252) supports use of oral amoxicillin–clavulanate for respiratory exacerbations in children. By day 14, resolution was observed in 41 (65%) children in the amoxicillin–clavulanate group, 41 (61%) in the azithromycin group, and 29 (43%) in the placebo group.
UKMi comment

Compared with placebo, relative risk for resolution by day 14 was 1.50 (95% CI 1.08–2.09, p=0.015; number-needed-to-treat [NNT] 5 [95% CI 3–20]) in the amoxicillin–clavulanate group versus 1.41 (1.01–1.97, p=0.042; NNT 6 [3–79]) in the azithromycin group.

Authors of a related commentary state oral amoxicillin–clavulanate treatment is beneficial in terms of resolution of non-severe exacerbations of bronchiectasis in children, and should remain the first-line oral antibiotic in this setting.
Related links: Commentary