Home > Pulmonology > ERS 2018 > COPD: Triple therapy, MABA and antibiotics > Macrolide Antibiotics and Trial with Azithromycin

Macrolide Antibiotics and Trial with Azithromycin

Presented By
Prof. Wim Janssens, University Hospital Leuven, Belgium
Conference
ERS 2018
Trial
BACE

No widespread use of macrolide antibiotics

Despite inhalation therapy, 20-50% of patients experience ≥1 exacerbation per year. Acute exacerbations of COPD (AECOPD) are associated with acute worsening of symptoms necessitating medical intervention. 20-25% of exacerbations require hospitalisation, which has a bad prognosis: 6% in-hospital mortality, 12% mortality within 3 months, and 35% risk of readmission. Macrolide antibiotics possess both anti-microbial and anti-inflammatory properties. The role of azithromycin for the prevention of COPD exacerbations was established in 2011 by the publication of a multicentre RCT, showing a 30% reduction of acute exacerbations during a chronic treatment with azithromycin. However, there has not been a widespread use of azithromycin. “That was mainly because of major safety concerns, being cardiac safety (QTc prolongation) and bacterial resistance”, explained Prof. Wim Janssens (University Hospital Leuven, Belgium).

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