Azithromycin for acute bronchitis: a randomised, double-blind, controlled trial.
BACKGROUND
The value of azithromycin for treatment of acute bronchitis is unknown, even though this drug is commonly prescribed. We have investigated this question in a randomised, double-blind, controlled trial.


METHODS
Adults diagnosed with acute bronchitis, without evidence of underlying lung disease, were randomly assigned azithromycin (n=112) or vitamin C (n=108) for 5 days (total dose for each 1.5 g). All individuals were also given liquid dextromethorphan and albuterol inhaler with a spacer. The primary outcome was improvement in health-related quality of life at 7 days; an important difference was defined as 0.5 or greater. Analysis was by intention to treat.


RESULTS
The study was stopped by the data-monitoring and safety committee when 220 patients had been recruited. On day 7, the adjusted difference in health-related quality of life was small and not significant (difference 0.03 [95% CI -0.20 to 0.26], p=0.8). 86 (89%) of 97 patients in the azithromycin group and 82 (89%) of 92 in the vitamin C group had returned to their usual activities by day 7 (difference 0.5% [-10% to 9%], p>0.9). There were no differences in the frequency of adverse effects; three patients in the vitamin C group discontinued the study medicine because of perceived adverse effects, compared with none in the azithromycin group. Most patients (81%) reported benefit from the albuterol inhaler.


CONCLUSIONS
Azithromycin is no better than low-dose vitamin C for acute bronchitis. Further studies are needed to identify the best treatment for this disorder.
Evans
Arthur T
AT
Collaborative Research Unit, Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, IL 60612, USA. aevans@cchil.org
Husain
Shahid
S
Durairaj
Lakshmi
L
Sadowski
Laura S
LS
Charles-Damte
Marjorie
M
Wang
Yue
Y
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use*; D001991:Bronchitis / Q000188:drug therapy*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D017963:Azithromycin; D001205:Ascorbic Acid