LONG-TERM AZITHROMYCIN TREATMENT IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Purpose: To assess the efficacy of Azithromycin on exacerbations in patients with chronic obstructive pulmonary disease (COPD) and history of two or more flare-ups in the last 12 months and to study the influence of concomitant bronchiectasis on its effect. Material/Methods: We prospectively observed 60 COPD patients with frequent exacerbations and predominantly severe disease (mean forced expiratory volume in 1 second [FEV1] – 44%). Addition of six-month intermittent Azithromycin (500 mg three times weekly) to standard therapy was compared to standard therapy only in respect to exacerbation frequency and time to first exacerbation. Results: Azithromycin, in comparison to standard therapy, led to a higher reduction of exacerbation frequency (-1.47 vs -0.87 events per patient-year) but did not affect hospitalization frequency (-0.57 vs. -0.53 events per patient-year). The time to first exacerbation was longer in the macrolide group (233 days) than in the control group (125 days) (P=0.011). Bronchiectasis did not influence the effect of tested macrolide on exacerbations. No significant effect on lung function, symptoms, quality of life, physical capacity and sputum and throat swab microbiology was found. Conclusions: Azithromycin reduced the frequency of exacerbations and delayed the time to first exacerbation. The effect was independent on the presence of bronchiectasis.

Keywords

• chronic obstructive pulmonary disease
• bronchiectasis
• exacerbations
• azithromycin