Azithromycin for the Prevention of COPD Exacerbations: The Good, Bad, and Ugly.
Long-term azithromycin therapy has been shown to reduce exacerbations of chronic obstructive pulmonary disease (COPD), and is recommended by recent society guidelines for use in COPD patients who are at risk for recurrent exacerbations. However, concerns about adverse effects have limited its widespread adoption. Physicians deciding whether to use long-term azithromycin therapy must weigh each patient's individual risk of cardiovascular complications and both the individual and population impact of macrolide resistance against the expected benefit. This review will summarize evidence on the effectiveness and safety of chronic azithromycin for the prevention of COPD exacerbations.
Department of Internal Medicine, Carolinas Medical Center, Charlotte, NC. Electronic address: stephanie.p.taylor@carolinashealthcare.org.
Stephanie Parks
SP
Taylor
Department of Internal Medicine, Medical University of South Carolina, Charleston.
Eric
E
Sellers
Department of Internal Medicine, Division of Pulmonary and Critical Care, Carolinas Medical Center, Charlotte, NC.
Brice T
BT
Taylor
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017963:Azithromycin / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000139:chemically induced; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000188:drug therapy; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D017963:Azithromycin
Azithromycin; COPD exacerbation; Macrolide; QT prolongation