title: Meta-analysis of the adverse effects of long-term azithromycin use in patients with chronic lung diseases.
abstract: The adverse effects of azithromycin on the treatment of patients with chronic lung diseases (CLD) were evaluated in the present study. MEDLINE and other databases were searched for relevant articles published until August 2013. Randomized controlled trials that enrolled patients with chronic lung diseases who received long-term azithromycin treatment were selected, and data on microbiological studies and azithromycin-related adverse events were abstracted from articles and analyzed. Six studies were included in the meta-analysis. The risk of bacterial resistance in patients receiving long-term azithromycin treatment was increased 2.7-fold (risk ratio [RR], 2.69 [95% confidence interval {95% CI}, 1.249, 5.211]) compared with the risk in patients receiving placebo treatment. On the other hand, the risk of bacterial colonization decreased in patients receiving azithromycin treatment (RR, 0.551 [95% CI, 0.460, 0.658]). Patients receiving long-term azithromycin therapy were at risk of increased impairment of hearing (RR, 1.168 [95% CI, 1.030, 1.325]). This analysis provides evidence supporting the idea that bacterial resistance can develop with long-term azithromycin treatment. Besides the increasingly recognized anti-inflammatory role of azithromycin used in treating chronic lung diseases, we should be aware of the potential for adverse events with its long-term use.
authors.affiliation: Division of Respiratory Medicine, the Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.forename: Ding-Hui
authors.initials: DH
authors.lastname: Liu
authors.forename: Lu-Lu
authors.initials: LL
authors.lastname: Chen
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhao
authors.forename: Yan-Zhe
authors.initials: YZ
authors.lastname: Yu
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Ding
authors.forename: Li-Yun
authors.initials: LY
authors.lastname: Miao
authors.forename: Yong-Long
authors.initials: YL
authors.lastname: Xiao
authors.forename: Hou-Rong
authors.initials: HR
authors.lastname: Cai
authors.forename: De-Ping
authors.initials: DP
authors.lastname: Zhang
authors.forename: Yu-Biao
authors.initials: YB
authors.lastname: Guo
authors.forename: Can-Mao
authors.initials: CM
authors.lastname: Xie
mesh_terms: D017963:Azithromycin / Q000009:adverse effects* / Q000627:therapeutic use*; D002908:Chronic Disease / Q000188:drug therapy*; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy*
chemical_list: D017963:Azithromycin