Naderi N, et al. - Authors assessed the efficacy of long-term azithromycin to reduce exacerbations in severe COPD patient on optimal therapy in real-life practice. Reduction in the exacerbation numbers in severe COPD patients and benefits persisting beyond one year were seen with long-term azithromycin use. In patients colonized with Pseudomonas aeruginosa, desirable impacts were more likely to outweigh the risks and adverse events.

Methods

• Experts carried out a retrospective observational study of severe COPD patients who were prescribed azithromycin (PA)(250 mg, at least 3 times weekly for at least 6 months).
• In the comparison group included severe COPD patients not prescribed azithromycin (NPA) were included.
• They extracted the data from clinical chart review.

Results

• As per the data, study included 126 PA and 69 NPA patients.
• Severe airflow obstruction was noted in them, mostly emphysema and one-third bronchiectasis.
• Results demonstrated respiratory tract colonization with Pseudomonas aeruginosa to be a predominant feature in the PA group.
• Findings suggested the mean number of exacerbations per patient per year in the PA group to be 3.2 ± 2.1 before initiating azithromycin, and 2.3 ± 1.6 during following year on therapy (p < 0.001).
• During first and second follow-up year, patients in the NPA group had 1.7 ± 1.3 and 2.5 ± 1.7 exacerbations respectively (p < 0.001).
• Authors noted that the exacerbation changes from pre to post differed between groups (p < 0.001).
• A significant decrease in emergency visits and hospital admissions in PA group was seen .
• They found that exacerbation reductions and patient proportions having ≥2 exacerbations extended to the second year of treatment.