PT  - JOURNAL ARTICLE
AU  - Simon Twite
AU  - Paul Stockton
AU  - Sanjeev Agarwal
TI  - Azithromycin, a novel maintenance therapy in patients with chronic non-CF suppurative lung disease
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p2544
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p2544.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p2544.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Patients with bronchiectasis experience lower respiratory tract infections with decline in quality of life. The British Thoracic Society statement indicates that Macrolides may have disease-modifying activity. A definite recommendation for there use is not made in non-CF bronchiectasis. We present experience of Azithromycin in non-CF bronchiectaisis as well as other respiratory diseases at a large district general teaching hospital.137 patients were identified on maintenance Azithromycin therapy during a 12 month period. 66% received Azithromycin 250mg daily. Azithromycin provided a significant improvement in the mean time between exacerbations/rescue antibiotics, in patients with non-CF bronchiectasis as well as other lung conditions. The mean time to exacerbation was 64 days, without Azithromycin (range 30-360 days) versus 304.5 days, with Azithromycin (range 14-582 days). 48 patients required no rescue antibiotics. Where Azithromycin was electively withdrawn, the patients clinically worsened. This strategy is therefore not recommended. Treatment failure due to side effects only occurred in those patients on a 500mg three times weekly regime. Discussion in the literature raises concerns with atypical mycobacteria, potential for increased colonisation rates and drug resistance. No such concerns were seen in this series. In this series, Azithromycin provided clinical improvement in patients with other non-CF lung disease processes but further studies are needed in this population.The recommended regime from this study, in those patients with non-CF bronchiectasis is Azithromycin 250mg PO daily.