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    The International Journal of Chronic Obstructive Pulmonary Disease Indexed- American Chemical Society's Chemical Abstracts Service CAS- PubMed files to appear soonISSN 1176-9106 PrintISSN 1178-2005 OnlineAn international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. metformin vs insulin Title Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma AMAZES a randomised, double-blind, placebo-controlled trial Gibson, PG et al. Chronic obstructive pulmonary disease COPD is a type of obstructive lung disease characterized by long-term breathing problems and poor airflow. The main symptoms include shortness of breath and cough with sputum production. COPD is a progressive disease, meaning it typically worsens over time. Eventually everyday activities, such as walking or getting dressed, become difficult.

    Asthma exacerbations in adults are usually caused by viral respiratory infections, but bacterial infections, allergens, pollutants, and other causes may also trigger them. Despite the relatively low likelihood of a bacterial etiology, and guideline recommendations against routine antibiotic therapy (British Guideline on Acute Asthma 2016, National Heart, Lung, and Blood Institute Guidelines for the Diagnosis and Management of Asthma 2007), antibiotics are often prescribed for asthma exacerbations, including 22% of emergency room visits in the United States (Acad Emerg Med 2008 Aug;15(8):736). Evidence directly assessing antibiotic efficacy for asthma exacerbations is limited (Cochrane Database Syst Rev 2001;(3): CD002741), and in the highest quality trial to date that does show a benefit, treatment with telithromycin 800 mg/day for 10 days reduced symptom severity by only a mean of 0.3 points on a 6 point scale (N Engl J Med 2006 Apr 13;354(15):1589). To better investigate the possible efficacy of antibiotic use for asthma exacerbation, the AZALEA trial (JAMA Intern Med 2016 Sep 19 early online) randomized 199 adults presenting to the emergency department in the United Kingdom for acute asthma exacerbation to azithromycin 500 mg vs. placebo once daily for 3 days and followed them until day 10. Only patients requiring systemic corticosteroids for the exacerbation were included in this trial, and patients were excluded if they had any systemic antibiotic therapy during the previous 28 days or had other serious cardiopulmonary conditions. Patients recorded symptom severity on a 6 point scale in a diary once daily. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Current treatments for asthma attacks are not completely effective and new and better treatments are needed. Listing a study does not mean it has been evaluated by the U. Viruses often cause asthma attacks and bacterial lung infections have also been associated with asthma attacks. Current asthma guidelines for doctors treating asthma exacerbations do not recommend the routine use of antibiotics. Acute attacks (exacerbations) of asthma are common and cause a great deal of suffering in asthmatic patients. The investigators would like to investigate whether or not azithromycin, which is a safe and well tolerated antibiotic (an antibacterial) that has been used for many years in the treatment of respiratory disease, might be of benefit in asthma attacks. As there is some evidence that azithromycin has anti-viral properties this may add to its benefits (antibiotics don't usually affect viruses). By looking at the effect of azithromycin on asthma attacks this will help us to show whether or not azithromycin should be recommended during an acute asthma attack in addition to the usual care that is provided to these patients as it may help them recover quicker from the exacerbation. The investigators will also be able to look at why azithromycin may be effective - if it is having an anti-bacterial and/or anti-viral effect.

    Azithromycin asthma exacerbation

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