AZithromycin Therapy in Preschoolers With a Severe Wheezing Episode Diagnosed at the Emergency Department

Who can take part

• Age 18 months to <60 months
• The presence of expiratory wheezing as ascertained by a physician or nurse practitioner at admission to the ED
• A Pediatric Respiratory Assessment Measurement (PRAM) score of greater than or equal to 4 at any time during the ED admission

Who cannot take part

• Current or previous use of systemic antibiotics within the last 2 weeks
• Current or previous use of a steroid for wheezing within the last 2 weeks
• Received oxygen for more than 5 days in the neonatal period, or received invasive mechanical ventilation
• Participation in the evaluation of a drug or medical device currently or within the last 30 days
• Previous enrollment into this trial
• Presence of acute infection that requires systemic antibiotics, as determined by the physician
• A known systemic illness (other than allergy) including but not limited to:; Recurrent seizures; Gastroesophageal reflux (GER) requiring medical treatment; Major congenital anomalies; Physical and intellectual delay; Cerebral palsy; A history of chest surgery; Tuberculosis or other chronic infections; Primary or secondary immunodeficiency; Gastrointestinal malformation or disease; Cardiac disorder (except for a hemodynamically insignificant atrial septal defect (ASD), ventricular septal defect (VSD) or benign heart murmur)
• Significant developmental delay / failure to thrive, defined as a child plotting less than 3rd percentile
• Any chronic lung disease
• Known sensitivity or allergy to AZ
• Positive PCR or antigen test for COVID-19 from hospital/doctor's office/testing center within the past 30 days
• Born at less than 36 weeks estimated gestational age
• Suspected foreign body induced aspiration during the last 2 weeks
• The study intervention poses undue risk to patient in the opinion of the treating physician
• Inability of the parent or guardian to speak English or Spanish