[Correspondence] Mass azithromycin distributions: balancing childhood mortality and antimicrobial resistance

Azithromycin mass drug administration (MDA) reduces childhood mortality, but benefits should be balanced against risks of antimicrobial resistance (AMR).1,2 In The Lancet Infectious Diseases, Akuzike Kalizang'oma and colleagues reported on the 3·5 years of follow-up after an earlier trial of twice-yearly azithromycin (around 20 mg/kg) intervention versus placebo for 2 years (MORDOR).3 Nasopharyngeal pneumococcus was isolated from swabs obtained from children aged 1–9 years and antibiotic resistance genes were identified with short-read whole-genome sequencing.