Daily versus weekly azithromycin in cystic fibrosis patients

¹ University of Queensland Department of Medicine & Infectious Diseases, Mater Adult Hospital, South Brisbane, 4101, Queensland, Australia: Fax + 61 738401548 E-mail: jmccorma@mater.org.au
² Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Chermside, 4032, School of Medicine, University of Queensland, Australia.
³ Royal Children's Hospital, Herston, 4029, Department of Paediatrics and Child Health, University of Queensland, Australia.
⁴ Adult Cystic Fibrosis Unit, Mater Adult Hospital, South Brisbane, 4101, Queensland, Australia.
⁵ Mater Children's Hospital, South Brisbane, 4101, Queensland, Australia.

	Abstract

Four randomised placebo controlled trials (RCT) have documented the clinical benefits of azithromycin (AZM) in cystic fibrosis (CF) patients. In this study we examined if the beneficial effect of AZM is equivalent when administered daily or weekly.

Our trial was a double-blinded, randomised study of 208 CF patients aged 6-58 years who were assigned to 250mg daily (103) or 1200mg weekly (105) AZM for six months with assessments at baseline and months one, three, six and seven. Patients came from five adult and children's CF centres in Southeast Queensland, Australia.

Equivalence was demonstrated between the two groups with respect to improvements in lung function (FEV₁ and FVC), C reactive protein, days spent in hospital, admission rates or nutrition (BMI and z scores) was demonstrated between the two groups (daily and weekly) using 95% confidence intervals with a tolerance interval of +/- 10% In patients less than 18 years old the daily group had significantly better improvements in z scores for height and weight after six months of the study. In children, we found a nutritional advantage for daily administration. Gastrointestinal adverse effects were more common with weekly therapy. Apart from these findings daily and weekly administered AZM demonstrated similar outcomes for CF patients,

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