Long-Term Use of Antibiotic May Help Those With COPD

Taking azithromycin for a year cut down on re-hospitalizations for disease flare-ups, study found

By Alan Mozes

Tuesday, May 21, 2013

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TUESDAY, May 21 (HealthDay News) -- Thousands of Americans, many of them smokers or ex-smokers, suffer from the lung condition known as chronic obstructive pulmonary disease (COPD). Now a new study finds that patients placed on the common antibiotic azithromycin may be able to cut down on hospitalizations due to flare-ups of the disease.
"Given that exacerbations of COPD can be life-threatening, prevention of such events is critical," said Victoria Richards, assistant professor of medical science at Quinnipiac University in Hamden, Conn. Use of the antibiotic might also cut down on the need for doctor's office visits and boost patients' quality of life, said Richards, who was not involved in the study.
The research was presented Tuesday at the annual meeting of the American Thoracic Society in Philadelphia.
COPD is a progressive disease involving bronchitis and emphysema, often tied to smoking, that makes it hard for patients to breathe.
In the new study, researchers compared how patients fared on a 12-month regimen of the drug versus patients who were given a dummy medication.
"COPD patients who have been hospitalized for a respiratory event are at particularly high risk for re-hospitalization," study lead author Dr. Fernando Martinez said in a meeting news release.
"We wanted to examine whether chronic azithromycin therapy might provide a benefit in these patients," said Martinez, who is director of pulmonary diagnostic services at the University of Michigan Health System, in Ann Arbor.
To assess treatment effectiveness, the researchers looked at data from a prior study conducted by the COPD Clinical Research Network.
Patients in that study had either suffered a so-called "acute exacerbation" of COPD in the year leading up to the study or were using supplemental oxygen at the beginning of the study.
For one year the patients randomly were assigned to receive either a daily dose of 250 milligrams of azithromycin or a placebo.
The result: Compared with the placebo group, patients taking the antibiotic were able to benefit from longer gaps between hospitalizations.
"We found that there was a significant delay from the first respiratory-related hospitalization to the next one among those treated with azithromycin," Martinez said. He said the finding also held for re-hospitalizations that were due to any cause, not just respiratory issues.
One expert said the findings warrant further investigation, but pointed out that the history of antibiotic use in people with respiratory disease has had its ups and downs.
"A number of years ago, it was reported that Ketak, an antibiotic in the erythromycin family, was helpful in reducing exacerbations in asthma," said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City. "[However], there were other problems with this antibiotic, and it was discontinued."
He called the new findings with azithromycin "promising," but added a caveat: "It was recently found that azithromycin is contraindicated in patients with cardiac arrhythmia, which [can] occur in COPD, so these factors must be viewed with caution."
For his part, Martinez said more research will need to be done to confirm the findings, and experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

SOURCES: Victoria Richards, Ph.D., assistant professor, medical sciences, Frank H. Netter M.D. School of Medicine, Quinnipiac University, Hamden, Conn; Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; news release, American Thoracic Society annual meeting, Philadelphia

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