title: Efficacy of azithromycin in sepsis-associated acute respiratory distress syndrome: a retrospective study and propensity score analysis.
abstract: OBJECTIVE
  Acute respiratory distress syndrome is a life-threatening form of respiratory failure without an established pharmacological treatment. Recently, macrolides have been found to be beneficial in cases of acute lung injury, but evidence is limited.
  
  
  METHODS
  This single-centre retrospective cohort evaluation of hospitalized patients with sepsis-associated acute respiratory distress syndrome aimed to assess the impact of azithromycin on clinical outcomes by using a propensity score analysis. All data were collected prospectively as part of ongoing research on high-resolution computed tomography of acute respiratory distress syndrome. The primary outcome was 60-day mortality; the secondary outcome was the number of ventilator-free days.
  
  
  RESULTS
  Twenty-nine of 125 patients with sepsis-associated acute respiratory distress syndrome (23.2 %) received azithromycin within 24 h after acute respiratory distress syndrome diagnosis. After adjusting for potentially confounding covariates, azithromycin use was associated with lower 60-day mortality (hazard ratio, 0.31; 95 % confidence interval, 0.11-082; P = 0.02) and a shorter time to successful discontinuation of mechanical ventilation.
  
  
  CONCLUSIONS
  Azithromycin use was associated with decreased mortality and ventilator dependency in patients with sepsis-associated acute respiratory distress syndrome. Further well-designed prospective studies are needed.
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Kodai
authors: K
authors: Kawamura
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Kazuya
authors: K
authors: Ichikado
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Makoto
authors: M
authors: Takaki
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Yoshihiko
authors: Y
authors: Sakata
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Yuko
authors: Y
authors: Yasuda
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Naoki
authors: N
authors: Shingu
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Aoi
authors: A
authors: Tanaka
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Jyunpei
authors: J
authors: Hisanaga
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Yoshitomo
authors: Y
authors: Eguchi
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Keisuke
authors: K
authors: Anan
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Tatuya
authors: T
authors: Nitawaki
authors: Division of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc., Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto 861-4193 Japan.
authors: Moritaka
authors: M
authors: Suga
keywords: ARDS; Azithromycin; Macrolide; Prognosis; Propensity score; Ventilator-free days