Macrolide and Nonmacrolide Resistance with Mass Azithromycin Distribution

RCT in Niger (1046 samples from 29 villages) found that among villages assigned to receive mass distributions of azithromycin or placebo twice yearly for 4 years, antibiotic resistance was more common in the villages that received azithromycin than in those that received placebo.

SPS commentary:

The study, which investigates the gut resistome of children, also found that continued mass azithromycin distributions selected for determinants of nonmacrolide resistance, including resistance to beta-lactam antibiotics.

New England Journal of Medicine