Antibiotics cut COPD exacerbations

Antibiotic treatment of COPD with azithromycin reduces exacerbations by a quarter, but may affect some patients' hearing, a US study suggests.

COPD patients were treated with azithromycin for a year (Photograph: SPL)
COPD patients were treated with azithromycin for a year (Photograph: SPL)

However, the impact of such a treatment strategy on antibiotic resistance is not yet known, researchers warned.

Dr Richard Albert and colleagues from the US COPD Clinical Research Network examined the effect of treatment on 1,142 patients.

Patients enrolled in the trial were at increased risk of COPD exacerbations but had no hearing impairment.

Also, because of the effect of azithromycin on QT interval, patients at apparent risk of prolongation of corrected QT interval were excluded.

Patients were randomised to receive either azithromycin 250mg daily or a placebo for one year.

Those given azithromycin experienced exacerbation after an average of 266 days, compared with 174 days for patients given placebo.

Frequency of exacerbations was 1.48 per patient-year in the azithromycin group, compared with 1.83 in the placebo group. Patients given azithromycin were 27% less likely to experience an exacerbation within the year of treatment.

However, hearing decrements were experienced by 25% of the azithromycin group, compared with 20 per cent of the placebo group.

The researchers said: 'Given the deleterious effects of acute exacerbations of COPD with respect to the risk of death, quality of life, loss of lung function, and cost of care, adding azithromycin to the treatment regimen of patients who have had an acute exacerbation of COPD within the previous year or who require supplemental oxygen is a valuable option.'

The researchers said patients should be screened for risk of prolongation of corrected QT interval and have their hearing monitored.

They added: 'It should be recognised that the long-term effects of this treatment on microbial resistance in the community are not known.'

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Party manifestos offer 'too little too late' on NHS pension tax crisis

Party manifestos offer 'too little too late' on NHS pension tax crisis

Political parties are offering 'too little too late' in their manifestos over the...

GPs report rising workload linked to record hospital waiting times

GPs report rising workload linked to record hospital waiting times

Eight in 10 GPs say rising waits for NHS hospital treatment have driven up workload...

Viewpoint: 'Why the RCGP should not adopt a neutral stance on assisted dying'

Viewpoint: 'Why the RCGP should not adopt a neutral stance on assisted dying'

The RCGP is currently surveying members for their views on assisted dying. In response...

Hurried GP consultations 'a scandal', RCGP chair warns

Hurried GP consultations 'a scandal', RCGP chair warns

Hurried consultations in general practice are 'a scandal that needs to be named'...

GMC labels overseas GP registration 'unfit for purpose' as British doctor denied work

GMC labels overseas GP registration 'unfit for purpose' as British doctor denied work

The GMC has labelled the system for registering overseas doctors as 'unfit for purpose'...

Which parts of England are facing a GP retirement timebomb?

Which parts of England are facing a GP retirement timebomb?

In parts of England more than 40% of the GP workforce in permanent roles is aged...