Adding a common antibiotic to the usual daily treatment regimen for chronic obstructive pulmonary disease (COPD) can reduce the occurrence of acute exacerbations and improve quality of life, reports new results from a clinical trial funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. 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. “Acute exacerbations account for a significant part of COPD’s health burden,” said Susan B. Azithromycin is already prescribed for a wide variety of bacterial infections including pneumonia and strep throat. “These promising results with azithromycin may help us reduce that burden and improve the lives of patients at risk.” COPD exacerbations are sudden onsets of worsened cough, wheeze, and labored breathing which are typically induced by bacterial and/or viral infection. Participants had a history of exacerbations in the previous year or needed oxygen therapy. The 570 study participants who took 250 milligrams 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. Eighty percent of the study participants were already taking other medications normally used to manage COPD, including inhaled steroids and long-acting bronchodilators. This multicentre study randomised 1142 subjects at risk of acute exacerbations of chronic obstructive pulmonary disease (COPD) to receive azithromycin 250 mg daily (n=570) or placebo (n=572) for 1 year, in addition to usual care. The enrolled subjects were allowed to continue on inhaled treatments and/or oxygen. The primary outcome, time to the first exacerbation, was significantly increased to 266 days (95% CI 227 to 313) in the azithromycin group compared with 174 days (95% CI 143 to 215) in the placebo group. The HR for having an acute exacerbation of COPD per patient-year was 0.73 in the azithromycin group compared with the placebo group. The secondary outcomes included quality of life measures (St George's Respiratory Questionnaire (SGRQ) scores), which improved more in the azithromycin compared with the placebo group. There was no significant reduction in hospitalisation rates and emergency department or urgent care visits and no difference in mortality. Hearing loss was more common in the azithromycin group and increased colonisation with macrolide resistant pathogens was noted. The authors concluded that the addition of azithromycin to usual care of COPD patients who have had an acute exacerbation in the last year or require oxygen supplementation is a valuable option but careful patient selection is required with the exclusion of patients with or at risk of QTc prolongation, resting tachycardia (100 beats per minute) and hearing defect.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Azithromycin, an antibiotic, may be beneficial at reducing the symptoms and severity of the disease. Listing a study does not mean it has been evaluated by the U. This study will analyze previously collected study data to evaluate the anti-inflammatory properties of azithromycin and determine how azithromycin affects the frequency and severity of COPD exacerbations. Chronic obstructive pulmonary disease (COPD) is a chronic lung disease. COPD is a disease in which the lung airways are partly damaged and obstructed, making it difficult to breathe. The most common cause is cigarette smoking, but breathing in other types of lung irritants, including pollution, dust, and chemicals, over a long period of time may also contribute to COPD. It is the fourth leading cause of death in the United States. Symptoms include coughing, excess mucus production, shortness of breath, wheezing, and chest tightness. Generic Name: azithromycin (a ZITH roe MYE sin)Brand Names: Azasite, Azithromycin 3 Day Dose Pack, Azithromycin 5 Day Dose Pack, Zithromax, Zithromax TRI-PAK, Zithromax Z-Pak, Zmax Medically reviewed by Sophia Entringer, Pharm D. Azithromycin is an antibiotic that fights bacteria. Azithromycin is used to treat many different types of infections caused by bacteria, such as respiratory infections, skin infections, ear infections, eye infections, and sexually transmitted diseases. Azithromycin may also be used for purposes not listed in this medication guide. You should not use azithromycin if you have ever had jaundice or liver problems when you have previously taken this medicine. You should not use azithromycin if you are allergic to it, or if: This medicine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether azithromycin passes into breast milk or if it could harm a nursing baby. Take azithromycin exactly as prescribed by your doctor. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Accepted for publication 7 November 2015 Published 31 March 2016 Volume 20(1) Pages 687—696 DOI https://doi.org/10.2147/COPD. S95501 Checked for plagiarism Yes Review by Single-blind Peer reviewers approved by Professor Hsiao-Chi Chuang Peer reviewer comments 6 Editor who approved publication: Dr Richard Russell Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium Background: Long-term use of macrolide antibiotics is effective to prevent exacerbations in chronic obstructive pulmonary disease (COPD). As risks and side effects of long-term intervention outweigh the benefits in the general COPD population, the optimal dose, duration of treatment, and target population are yet to be defined. Hospitalization for an acute exacerbation (AE) of COPD may offer a targeted risk group and an obvious risk period for studying macrolide interventions. Methods/design: Patients with COPD, hospitalized for an AE, who have a smoking history of ≥10 pack-years and had ≥1 exacerbation in the previous year will be enrolled in a multicenter, randomized, double-blind, placebo-controlled trial (NCT02135354). On top of a standardized treatment of systemic corticosteroids and antibiotics, subjects will be randomized to receive either azithromycin or placebo during 3 months, at an uploading dose of 500 mg once a day for 3 days, followed by a maintenance dose of 250 mg once every 2 days. The primary endpoint is the time-to-treatment failure during the treatment phase (ie, from the moment of randomization until the end of intervention). Key clinical point: Initiating azithromycin in patients with COPD exacerbation at the time of hospitalization improves short-term outcomes. Major finding: Relative to placebo, azithromycin provided a borderline reduction in treatment failure (provided improvement in a variety of outcomes at 90 days, including risk of death, according to a placebo-controlled trial presented as a late-breaker at the annual congress of the European Respiratory Society. In patients with COPD, “azithromycin initiated in the acute setting and continued for 3 months appears to be safe and potentially effective,” reported Wim Janssens, MD, Ph D, division of respiratory medicine, University Hospital, Leuven, Belgium. The phrase “potentially effective” was used because the primary endpoint, which was time to treatment failure, fell just short of statistical significance ( = .003), were significantly lower in the group receiving azithromycin rather than placebo. In a previous trial, chronic azithromycin therapy on top of usual care in patients frequently hospitalized for COPD was associated with a reduction in the risk of exacerbations and an improvement in quality of life (). Janssens explained that this strategy is not commonly used because it was associated with a variety of adverse events, not least of which was QTc prolongation. The study at the meeting, called the, was designed to test whether azithromycin could be employed in a more targeted approach to control exacerbations. In the study, 301 COPD patients hospitalized with an acute exacerbation were randomized within 48 hours of admission to azithromycin or placebo. The primary outcome was time to treatment failure, a novel composite endpoint of any of three events: the need for treatment intensification, the need for step-up hospital care (either ICU admission or hospital readmission), or death by any cause.
Zithromax Azithromycin belongs to the family of medications known as macrolide antibiotics. It is used to treat certain types of infections that are caused by bacteria. Azithromycin is used to treat certain bacterial infections including sinusitis, pneumonia. It is a macrolide-type antibiotic. It works by stopping the growth of bacteria. This medication will not work for.