Effects of long-term low-dose azithromycin in patients with non-CF bronchiectasis

Summary We describe our institutional efficacy experience of azithromycin 250 mg thrice weekly in adult non-cystic fibrosis bronchiectasis. Methods Eligibility criteria for prophylactic azithromycin included 3 exacerbations requiring rescue antibiotics over the previous 6 months. The clinical records of 56 bronchiectasis patients on azithromycin were retrospectively reviewed. Exacerbation frequency, sputum microbiology, self-reported change in sputum volume, and spirometry results were recorded. Results Mean length of treatment was 9.1 months (7.5) and 50 patients had treatment ≥3 months. Spirometry, pre- and post-azithromycin in 29 patients, who had 3 or more months of treatment, showed a mean increase in FEV1 of 83 ml (0.14) ( P = 0.005) from 1.560 to 1.643 l. There was a decrease in the exacerbation frequency from 0.81/month (SD) (0.32) pre-azithromycin to 0.41/month (0.45) ( P < 0.001) post-azithromycin. Clinically significant suppression of previous sputum microbial isolates was also observed. Conclusion Azithromycin improves exacerbation frequency, spirometry, and sputum microbiology in bronchiectasis.