Azithromycin for Preschoolers with Wheezing: PECARN Randomized Trial in the ED

Title & citation

The article is titled “Azithromycin for Preschoolers with Wheezing in the Emergency Department.” It appears in the New England Journal of Medicine (N Engl J Med) and is cited as: 2026 Aug 20;395(8):753-764, doi: 10.1056/NEJMoa2516505. The PubMed identifier is PMID 42149992 and the PubMed Central identifier is PMCID PMC13186117. The electronic publication date listed is May 18, 2026.

Study type and trial group

The PubMed entry classifies the manuscript as a randomized controlled trial. The study is reported as being performed by the PECARN AZ-SWED Trial Study Group, indicating a pediatric emergency-care research network collaboration across multiple centers. The trial’s clinical focus is the administration of azithromycin to preschool children with wheezing who present to the emergency department (ED).

Authorship and institutional affiliations

Lead and contributing authors named on the PubMed record include Kurt R Denninghoff, T Charles Casper, Joseph J Zorc, Richard M Ruddy, Sarah Satola, Wendi-Jo Wendt, Claudia R Morris, Melissa M Tavarez, Matthew J Lipshaw, Maria Y Kwok, Jo-Ann O Nesiama, Kyle A Nelson, Michael Webb, Fernando D Martinez, and many collaborators listed collectively as the PECARN AZ-SWED Trial Study Group.

Contributing institutions and departments named in the citation include the Department of Emergency Medicine and the Arizona Emergency Medicine Research Center (University of Arizona), Departments of Pediatrics and the Utah Data Coordinating Center (University of Utah), Children’s Hospital of Philadelphia and Perelman School of Medicine (University of Pennsylvania), University of Cincinnati College of Medicine, Emory University Division of Infectious Diseases, Medical College of Wisconsin, Emory University School of Medicine/Children’s Healthcare of Atlanta, University of Pittsburgh School of Medicine/UPMC Children’s Hospital, University of Michigan, Columbia University Vagelos College of Physicians and Surgeons/NewYork-Presbyterian Morgan Stanley Children’s Hospital, University of Texas Southwestern/Children’s Medical Center Dallas, Boston Children’s Hospital/Harvard Medical School, and the Asthma and Airway Disease Research Center (University of Arizona).

Publication and indexing details

The PubMed record provides bibliographic metadata including journal name, issue, page range, DOI (10.1056/NEJMoa2516505), PMID (42149992), and PMCID (PMC13186117). A free full-text link is noted via PubMed Central. The record also lists extensive collaborator names, reflecting a large multicenter effort.

What is included in the PubMed excerpt

The PubMed excerpt reliably conveys the following factual elements:

• The trial title and principal subject: use of azithromycin for preschoolers with wheezing in the ED.
• Manuscript type: randomized controlled trial.
• Authorship and a comprehensive list of collaborators and their institutional affiliations.
• Complete bibliographic identifiers (journal, volume, pages, DOI, PMID, PMCID) and a link to the full text at PubMed Central.

These metadata are valuable for locating and citing the full report and for identifying the research network and participating centers.

What is not reported in this source excerpt

The PubMed snippet provided here does not include the trial’s substantive clinical content. Specifically, the following key methodological and outcome details are not present in this excerpt and therefore are not reported here:

• Sample size and enrollment numbers.
• Inclusion and exclusion criteria for enrollee selection (beyond the general population of preschool children with wheeze presenting to EDs).
• The precise azithromycin dosing regimen, duration of therapy, route of administration, or comparator/controls used in randomization.
• Primary and secondary endpoints (clinical effect measures such as symptom resolution, hospitalization rate, return visits, time to improvement, or antibiotic-related endpoints).
• Statistical analysis plan and measures of effect (relative risks, hazard ratios, confidence intervals, P values).
• Safety data and adverse-event reporting.
• Subgroup analyses, follow-up duration, or longer-term outcomes such as recurrence of wheeze or antibiotic resistance assessments.

Because these elements are absent from the PubMed display excerpt provided, no efficacy or safety conclusions can be drawn here. Any clinical interpretation requires consultation of the full text.

Where to find the full text and next steps for clinicians

The PubMed entry indicates a free full-text version is available via PubMed Central (PMCID PMC13186117). Clinicians or researchers wishing to review the trial’s methods, results, and implications should access that full article to obtain:

• Detailed trial protocol and randomization methods.
• Complete results for primary and secondary outcomes and accompanying statistical analyses.
• Safety and adverse-event data relevant to pediatric azithromycin use.
• Discussion and authors’ conclusions, including limitations and applicability to clinical practice.

Until those details are reviewed, clinical decision-making regarding routine use of azithromycin for preschool wheeze in the ED should not be based on the bibliographic entry alone. The metadata confirm the study’s existence, its randomized controlled design, and multicenter collaboration, but the excerpt does not supply the trial’s clinical findings or practice-changing conclusions.

Summary

This PubMed record documents a multicenter randomized controlled trial evaluating azithromycin in preschool children with wheeze presenting to emergency departments, published in N Engl J Med in 2026 by the PECARN AZ-SWED Trial Study Group. The excerpt provides comprehensive bibliographic and authorship information but lacks the trial’s methods, numerical results, safety data, and authors’ clinical conclusions. For complete, evidence-based assessment, consult the full text at the provided PMCID link.