A study examined whether mass administration of the antibiotic azithromycin to infants aged 1–11 months in Mali reduced mortality.[1] From December 2020 to December 2022, 1151 villages were included in the cluster-randomized trial, divided into a placebo group, a biannual azithromycin group, and a quarterly group.[1] A total of 149,090 infants received at least one dose of placebo or azithromycin, with a total follow-up of 82,600 person-years, during which 968 deaths were recorded.[1] Mortality was 11.9 deaths per 1000 person-years in the control group, 11.8 in the twice-yearly azithromycin group (IRR 1.00; 95% CI 0.83–1.19), and 11.3 in the quarterly group (IRR 0.93; 95% CI 0.75–1.15).[1] Thus, there was no difference between the groups in the mortality of infants or older, untreated children aged 12–59 months.[1] Adverse events were rare and their incidence was similar in all three groups.[1] The authors conclude that mass administration of azithromycin restricted to infants aged 1–11 months did not reduce mortality compared with placebo, regardless of frequency of administration.[1]