title: Long-term azithromycin therapy in patients with severe COPD and repeated exacerbations.
abstract: BACKGROUND
  The aim of this study was to determine whether long-term intermittent azithromycin therapy reduces the frequency of exacerbation in severe chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  We retrospectively investigated the clinical benefits of long-term azithromycin (500 mg orally three times per week) over 12 months in patients with severe COPD and a minimum of four acute exacerbations (AECOPD) per year or chronic bronchial colonization by Pseudomonas aeruginosa, comparing the number of AECOPD, hospitalizations due to respiratory disease, days of hospital stay, and bacterial infections during azithromycin treatment and in the year prior to this therapy.
  
  
  RESULTS
  Twenty patients who completed the 12-month treatment period were analyzed. No clinically significant adverse events were observed during azithromycin treatment. Compared with baseline data, azithromycin therapy significantly reduced the number of AECOPD (2.8 ± 2.5 versus 6.8 ± 2.8, P < 0.001), hospitalizations (1.4 ± 1.5 versus 3.6 ± 1.4, P < 0.001), and cumulative annual days of hospital stay (25 ± 32.2 versus 43.7 ± 21.4, P = 0.01). The improvement was particularly significant in patients with exacerbations caused by common potentially pathogenic microorganisms, who had 70% fewer AECOPD and hospitalizations. Patients colonized by P. aeruginosa had reductions of 43% in AECOPD and 47% in hospitalizations.
  
  
  CONCLUSIONS
  Long-term azithromycin is well tolerated and associated with significant reductions in AECOPD, hospitalizations, and length of hospital stay in patients with severe COPD.
authors: Pneumology Service, Corporació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain. jpomares@tauli.cat
authors: Xavier
authors: X
authors: Pomares
authors: Concepción
authors: C
authors: Montón
authors: Mateu
authors: M
authors: Espasa
authors: Jordi
authors: J
authors: Casabon
authors: Eduard
authors: E
authors: Monsó
authors: Miguel
authors: M
authors: Gallego
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain; D013183:Sputum / Q000382:microbiology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin