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" ... Before the trial, experts thought that a protective effect would most likely be due to reductions in respiratory infections, diarrhea, and malaria (in that order). Such a hypothesis seemed reasonable, given the activity of azithromycin against bacterial pathogens of the lungs and gastrointestinal tract and against the Plasmodium falciparumĀ apicoplast. Further study will be necessary to identify the mechanism by which azithromycin prevents death. Investigation is already underway. ... "