Clinical trial results show that adding the common antibiotic azithromycin to the usual daily treatment regimen for chronic obstructive pulmonary disease (COPD) can reduce the occurrence of acute exacerbations and improve quality of life. The findings of the National Heart, Lung, and Blood Institute funded clinical trial appear in the New England Journal of Medicine.
COPD exacerbations are sudden onsets of worsened cough, wheeze, and labored breathing which are typically induced by bacterial and/or viral infection. Azithromycin is already prescribed for a wide variety of bacterial infections including pneumonia and strep throat.
Previous research suggested that this antibiotic might work for COPD exacerbations, but this study was the first to enroll a large number of COPD patients and treat exacerbations with this drug over a long time.
Participants had a history of exacerbations in the previous year or needed oxygen therapy. Eighty percent of the study participants were already taking other medications normally used to manage COPD, including inhaled steroids and long-acting bronchodilators.
The 570 participants who took 250 mg of azithromycin daily for a year in addition to their usual care averaged 1.48 acute COPD exacerbations annually, compared to 1.83 exacerbations for the 572 participants who received their usual care without azithromycin. The participants taking azithromycin also assessed their own breathing ability and overall well-being more favorably on questionnaires.
Side effects of azithromycin during the study were minimal. The presence of microbes resistant to azithromycin increased in some patients, although no one developed a clinically evident infection. A small fraction of participants receiving azithromycin were found to have slight hearing loss, which is a known side effect of the drug. Azithromycin can also cause heart arrhythmias in susceptible people. No heart rhythm abnormalities were seen in study participants, though people with heightened risks for arrhythmias were not enrolled in the study, according to the researchers.
Source: National Heart, Lung, and Blood Institute