Arzika AM, et al. - In view of the Macrolides Oraux pour Réduire les Décés avec un Oeil sur la Resistance (MORDOR) trial indicating the efficacy of distributing the antibiotic azithromycin to all preschool children in communities in Niger for preventing childhood mortality, researchers examined if a reduction in the community burden of malaria could be achieved via mass distribution of azithromycin, which has modest antimalarial activity. In Niger, 30 rural communities from the MORDOR trial were randomized to 2 years of biannual mass distributions of either azithromycin (20 mg/kg oral suspension) or placebo to children aged 1 to 59 months. At the baseline visit, the 15 azithromycin communities included a total of 1,695 children, and the 15 placebo communities included 3,029 children. Outcomes revealed a reduced prevalence of malaria parasitemia in correlation to mass azithromycin distributions which may, in turn, contribute to the mortality benefit of this intervention.