Additional therapy is sometimes required for adults who, despite maintenance treatment, have uncontrolled persistent asthma. The authors of a recent study aimed to assess the efficacy of Azithromycin, a macrolide antibiotic, as an add-on therapy.
In a randomised, double-blind, placebo controlled parallel group trial, patients with symptomatic asthma despite current use of inhaled corticosteroid and long acting bronchodilators were recruited. Patients were assigned randomly to either receive azithromycin (500mg) or placebo 3 times per week for 48 weeks. Groups were stratified for centre and past smoking status.
The researchers found that azithromycin reduced asthma exacerbations compared to placebo. Patients in the treatment group had an average of 1.07 severe or moderate exacerbations per year, compared to patients in the placebo group who had 1.86. Additionally, azithromycin appeared to improve quality of life. However, the diarrhoea was significantly more common in the treatment group.
The authors conclude that azithromycin may be a useful add-on therapy for patients with uncontrolled, persistent asthma.