Joint UK and Australia multicentre, randomised, double blind, placebo controlled pragmatic trial comparing 52 weeks of azithromycin to placebo in children with neurological impairment at risk of lower respiratory tract infection (the PARROT trial).

Children with neurological conditions such as cerebral palsy often have difficulty clearing mucus from their lungs due to muscle weakness and swallowing problems. This makes them much more prone to chest infections (lower respiratory tract infections), which can be serious — sometimes leading to hospitalisation, worsening of their condition, or even death. Despite this being a major health problem, there is very little evidence about the best way to prevent these recurring infections. The PARROT trial is a large international study (running in both Australia and the UK) testing whether a long-term course of the antibiotic azithromycin, taken once a week for 12 months, can reduce the number of chest infections and hospital admissions in children with neurological impairment. Half of the children will receive azithromycin and half will receive a placebo (an identical-tasting liquid with no active ingredient). Children and their families will be followed for up to 18 months. Your child may be eligible if they are aged 3–17 years, have a non-progressive neurological condition (such as cerebral palsy), have ongoing respiratory symptoms, and have been admitted to hospital with a chest infection or had at least two courses of antibiotics for chest infections in the past year. Children with progressive neurological conditions, cystic fibrosis, known allergy to macrolide antibiotics, or significant liver disease would not be eligible.