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According to a recent study published in the August 25 issue of the New England Journal of Medicine, azithromycin, a macrolide antibiotic has been found to reduce the frequency of exacerbations in patients with chronic obstructive pulmonary disease (COPD). The study, which was led by Richard K. Albert, MD, from Denver Health in Denver, Colorado, and colleagues from the COPD Clinical Research Network found that azithromycin, when administered daily for a year as an adjuvant to the normal treatment, reduces exacerbations in patients with COPD. However, its use resulted in hearing loss in a small percentage of patients.

 

A randomize controlled clinical trial, which screened 1577 patients of COPD and finally involved 1142 patients, was conducted between 2006 and 2010, to examine the effect of azithromycin on patients of COPD. The selected candidates were randomly divided into two groups. The first group, in addition to their usual treatment, received 250 gm of azithromycin daily for a year while the other group received a placebo. It was observed that the median time to exacerbation was 266 days in the azithromycin group as compared to 174 days in the placebo group. The first group reported 1.48 exacerbations per patient per year whereas the placebo group reported 1.83 exacerbations per patient per year. The hazard ratio for having an acute exacerbation of COPD per patient-year in the azithromycin group was 0.73. However, patients in the azithromycin group suffered from hearing decrements more commonly as compared to the placebo group (25% vs. 20%). 

 

Azithromycin decreases the frequency of exacerbations in patients of COPD by exerting immuno-regulatory, anti-inflammatory, and antibacterial effects. However, the researchers admit several shortcomings in the study which include evaluation of only a single-dose regimen and study duration limited to one year. The sputum samples analyzed were also partial.

 

References:

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