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Add-on Antibiotic Reduces Asthma Exacerbations

Azithromycin was found to effectively reduce the number of asthma exacerbations among adult patients with symptomatic asthma, according to a recent study.

The randomized, double-blind, placebo controlled, parallel group trial included 420 adult patients with symptomatic asthma despite the use of an inhaled corticosteroid and a long-acting bronchodilator. Of these patients, 213 were randomly assigned to receive 500 mg of azithromycin 3 times per week, and 207 were randomly assigned to receive a placebo 3 times per week for 48 weeks. The rate of total moderate and severe asthma exacerbations, and asthma-related quality of life were assessed as the primary endpoints.
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Over the 48 weeks of treatment, patients taking azithromycin had fewer asthma exacerbations and significantly improved asthma-related quality of life compared with patients who received the placebo. The proportion of patients who experienced at least 1 asthma exacerbation while taking azithromycin was lower than the proportion of patients in the placebo group (94 [44%] vs 127 [61%], respectively).

The most common adverse effect associated with azithromycin was diarrhea, which was reported in 72 (34%) patients who received the antibiotic compared with 39 (19%) patients who received the placebo.

“Adults with persistent symptomatic asthma experience fewer asthma exacerbations and improved quality of life when treated with oral azithromycin for 48 weeks,” the researchers concluded. “Azithromycin might be a useful add-on therapy in persistent asthma.”

—Melissa Weiss

Reference:

Gibson PG, Yang IA, Upham JW, et al. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial [published online July 4, 2017]. Lancet. http://dx.doi.org/10.1016/S0140-6736(17)31281-3