Azithromycin for the Prevention of COPD Exacerbations: The Good, Bad, and Ugly

Am J Med. 2015 Dec;128(12):1362.e1-6. doi: 10.1016/j.amjmed.2015.07.032. Epub 2015 Aug 17.

Abstract

Long-term azithromycin therapy has been shown to reduce exacerbations of chronic obstructive pulmonary disease (COPD), and is recommended by recent society guidelines for use in COPD patients who are at risk for recurrent exacerbations. However, concerns about adverse effects have limited its widespread adoption. Physicians deciding whether to use long-term azithromycin therapy must weigh each patient's individual risk of cardiovascular complications and both the individual and population impact of macrolide resistance against the expected benefit. This review will summarize evidence on the effectiveness and safety of chronic azithromycin for the prevention of COPD exacerbations.

Keywords: Azithromycin; COPD exacerbation; Macrolide; QT prolongation.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / adverse effects
  • Azithromycin / therapeutic use*
  • Cardiovascular Diseases / chemically induced
  • Humans
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Risk Factors

Substances

  • Anti-Bacterial Agents
  • Azithromycin