Azithromycin May Reduce Hospitalization Frequency in COPD Patients

COPD patients who took azithromycin daily for a year were re-hospitalized at significantly lower rates than those who took placebo.

Long-term azithromycin therapy appears to lengthen the time between hospital visits for patients with chronic obstructive pulmonary disease (COPD), according to a study presented at the American Thoracic Society 2013 International Meeting, which took place May 17-22 in Philadelphia.

Researchers used data collected from a previous study of azithromycin use conducted by the COPD Clinical Research Network. Patients included in the study had COPD and had experienced an acute exacerbation of COPD in the 12 months before the start of the trial or were using supplemental oxygen when they enrolled in the study. Participants were randomly selected to receive a daily 250 mg dose of azithromycin or placebo for 1 year.

Throughout the year, the researchers kept track of re-hospitalizations for all participants, noting the reason for the hospitalization and measuring the amount of time that passed between hospital visits for respiratory causes. They then compared the time between hospital visits for patients taking azithromycin and for those in the placebo group.

After performing post-hoc analyses and adjusting for age, gender, and other general health factors, the researchers found that the gap between the first respiratory-related hospitalization and the second was longer for patients receiving the antibiotic than for those receiving placebo. Forty days into the trial, approximately 10% of patients in both groups had been re-hospitalized. However, after 200 days, just 20% of patients treated with azithromycin had been re-hospitalized for a respiratory-related event compared with approximately 40% of patients receiving the placebo.

Patients taking the antibiotic experienced 156 respiratory-related hospitalizations compared with 200 hospitalizations for patients in the placebo group. The study also found that 31 patients receiving azithromycin and 49 patients taking placebo were re-hospitalized for respiratory reasons. Azithromycin patients also suffered fewer hospital visits overall; 45 were re-hospitalized for any reason compared with 65 re-hospitalized placebo patients. The researchers note that patients in both groups who were re-hospitalized were of similar age and gender and adhered to similar inhaled medication regimens.

Although their results suggest that azithromycin therapy may improve the health of COPD patients, the researchers concluded that additional studies need to be carried out to validate their findings and to determine whether the antibiotic is a viable therapy option for COPD patients. In addition, the researchers noted that the benefit of long-term antibiotic therapy needs to be balanced against the risk of increased antibiotic resistance.