Acute lower respiratory infections are a leading cause of recurrent hospitalisation, and early and repeated infections in young children increase the risk of chronic lung conditions such as bronchiectasis. Therefore, there is a desperate need to reduce the incidence of acute lower respiratory infections and to improve future lung health, especially for at-risk populations. The Team has shown that early and intermittent azithromycin treatment improves respiratory outcomes, and there is potential that long-term azithromycin may provide a good treatment option to reduce acute lower respiratory infections.


The aim of this study is to determine whether 12 months of weekly azithromycin, compared to placebo, improves the clinical outcomes of First Nation children hospitalised with an acute lower respiratory infection.

Secondary aims will determine the effect of 12 months of weekly azithromycin (compared to placebo) on:

  • The rates of acute lower respiratory infection hospitalisations in 12 months
  •  Chronic respiratory symptoms and signs of bronchiectasis
  • Serious adverse events
  • Antimicrobial resistance in the upper airway respiratory bacteria
  • The upper airway and gut microbiota
  • Cost-effectiveness

This study is funded by National Health and Medical Research Council (NHMRC) and being conducted in Darwin, Brisbane and New Zealand.

Lead investigator
Dr Gabrielle McCallum
Chief investigator
Dr Gabrielle McCallum and Professor Anne Chang
Project type
Project period