Management of the Chronically Inflamed Pediatric Airway

Objective: To examine our initial experience with the use of azithromycin in children with airway stenosis and chronically inflamed airways.Method: This retrospective study examined 20 children with airway stenosis and chronically inflamed airways. Patients tested negative for eosinophilic esophagitis and gastroesophageal reflux and took azithromycin (10 mg/kg) 3 times per week for at least a 1-month period. Outcomes were status of airway inflammation after azithromycin and decision to intervene on airway stenosis.Results: The mean age was 3.6 years (range 0.9-8.0) with 13 females and 7 males. Diagnoses included subglottic stenosis (85%), tracheal stenosis (5%), bronchial stenosis (5%), and bilateral vocal cord paralysis (5%). Mean duration of azithromycin therapy was 116.6 days (range 42-192). Airway inflammation improved in 14 patients (70%) allowing successful airway intervention in 12 patients. Two did not undergo surgery due to reasons other than airway inflammation. Six patients had persistent infla...