Efficacy of azithromycin in the treatment of bronchiectasis

Background and objectiveWe evaluated the efficacy of a 12-week oral treatment with azithromycin in adult patients with bronchiectasis. The objectives were to demonstrate that this treatment reduces sputum volume, improves quality of life and to assess the lengths of effects after cessation of therapy. MethodsSeventy-eight patients with bronchiectasis confirmed by high-resolution computed tomography were included in this study. Subjects received oral azithromycin or placebo in a randomized manner for 12 weeks followed by placebo for another 12 weeks. Sputum volume, St George's Respiratory Questionnaire (SGRQ) score and spirometry were recorded at baseline, 12 weeks and 24 weeks, respectively. End-point measurements were compared from baseline to the end of each study phase. ResultsSixty-eight subjects were included in the analysis. Mean 24-h sputum volume significantly decreased (P<0.01) during the active treatment phase and remained low during the control phase (P<0.01). The mean SGRQ total score with azithromycin decreased (i.e. improved health status) from baseline by more than the 4 points at the end of 12 and 24 weeks. Lung functions remained stable during oral azithromycin therapy and the subsequent control phase. ConclusionsTwelve weeks administration of azithromycin in bronchiectasis produces significant reductions in mean sputum volume, health status and stabilization of lung function values. Sputum volume reduction and the improvement of quality of life were sustained for 12 weeks after cessation of azithromycin. (Clinicaltrials.gov number NCT02107274). Macrolides are not established therapy to treat bronchiectasis, based on the evidence available. This study shows that azithromycin significantly reduces sputum volume and improves quality of life. The benefits persisted for 3 months after cessation of therapy.