Long-Term Use of Antibiotic May Reduce COPD Flare-Ups

Long-term use of the common antibiotic azithromycin has been proven to reduce the number of flare-ups in patients with chronic obstructive pulmonary disease (COPD), according to a recent study published in The New England Journal of Medicine.

When taken over the course of a year, azithromycin proved to reduce flare-ups in COPD patients by 20%. Typically, a person with moderate to severe COPD experiences one to three flare-ups each year. Minimizing these flare-ups can reduce hospitalization and improve quality of life.

The study, which was funded by the National Institutes of Health, assigned 570 patients with COPD to take 250mg of azithromycin daily for one year and 572 patients to take a placebo. Roughly 80% of patients in the study were also on other medication for COPD. Patients were on average aged 65, and all patients were on oxygen and reported having at least one flare-up in the previous year.

Compared to the placebo, the antibiotic reduced flare-ups by about 20%. After one year, those patients in the placebo group had on average 1.83 flare-ups, while those in the antibiotic group had 1.48. During the study, there were 156 COPD-related hospitalizations for the antibiotic group and 200 for the placebo group. The regimen has its downsides, researchers note. These include hearing loss, which has been found with other antibiotics, and an increase in antibiotic-resistant microbes in some patients.

Researchers note that the regimen is intended only for patients with moderate to severe COPD who require supplemental oxygen or have a history of flare-ups. Further, patients who have heart problems linked with abnormal rhythms are not good candidates for this treatment.

‘‘If you are in the ER a couple times a year or the hospital once a year and have frequent flare-ups more than twice a year, I think the benefits outweigh the risks here,” said researcher Mark Dransfield, M.D., director of the University of Alabama at Birmingham Lung Health Center, in an article published on WebMD.