Azithromycin to prevent exacerbations of chronic obstructive pulmonary disease: a study in the real-world setting

Abstract

Introduction: Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with a worsened quality of life, accelerated lung function decline, increased hospitalization and mortality. In patients on triple therapy who still have exacerbations chronic azithromycin may be considered. Aim: To assess the impact of chronic azithromycin on COPD exacerbations in a real-world setting. Methods: Retrospective cohort study including 32 COPD patients using maintenance azithromycin (500 mg three times per week) to reduce COPD exacerbations. Patients included had at least two exacerbations treated on an outpatient basis or one requiring hospitalization in the previous year (exacerbator phenotype). The number and severity of exacerbations 12 months before and after the start of azithromycin were identified in the patients9 electronic medical record. A p Results: The age was 65 ± 9 years, all patients were ex-smokers (61 ± 39 pack-years), the forced vital capacity (FVC) was 1.87 ± 0.65 l (54 ± 17% of predicted) and the forced expiratory volume in one second (FEV1) was 0.79 ± 0.36 (29 ± 12% of predicted). At the follow-up 13 of 32 patients (40.6%) using azithromycin had an exacerbator phenotype. Azithromycin significantly reduced both moderate and severe COPD exacerbations (p Conclusion: Our results shown that azithromycin significantly reduced moderate and severe COPD exacerbations in a real-world setting.