Abstract
Introduction: Bronchiectasis arises from an ongoing cycle of inflammation and bacterial colonization and has a major impact on a patient's wellbeing, mainly because of frequent infectious exacerbations.
Aim: Assessing the efficacy of longterm azithromycin treament over 1 year in patients with non-cystic fibrosis bronchiectasis in a randomized placebo controlled trial.
Methods: 89 patients from 14 sites were randomized to either azithromycin 250 mg daily or placebo, for 12 months. All were reviewed at three-monthly intervals during treatment and at 3 month's follow-up. At each review the following were assessed; exacerbation frequency (being the primary endpoint), lung function, qualitative and quantitative sputum bacteriology, serum and sputum inflammatory markers, adverse effects, symptom scores and St George's respiratory questionnaire. High resolution CT-scans were performed at study entrance and end of study.
Primary results: 81 patients completed the study. At the end of 12 month's treatment the azithromycin group showed a significant reduction in exacerbation frequency as compared to the placebo treated group (1,28/year, SD 1,32 vs 2,67/year, SD 1,95, p<0.0001). No significant differences were found with respect to lungfunction, inflammatory markers and adverse effects between groups.
Conclusions: Longterm azithromycin treatment significantly reduces exacerbation frequency in patients with non-CF bronchiectasis, without additional side effects.
- © 2011 ERS