Does prophylactic azithromycin reduce the number of COPD exacerbations or hospitalizations?
Q Does prophylactic azithromycin reduce the number of COPD exacerbations or hospitalizations? EVIDENCE-BASED ANSWER: Yes for exacerbations, no for hospitalizations. Prophylactic azithromycin reduces the number of exacerbations by about 25%. It also extends the time between exacerbations by approximately 90 days for patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Azithromycin benefits patients who are >65 years, patients with Global Initiative for Obstructive Lung Disease (GOLD) stage II or III COPD, former smokers, and patients using long-term oxygen; it doesn't benefit patients ≤65 years, patients with GOLD stage IV COPD, current smokers, or patients not using oxygen (strength of recommendation [SOR]: B, randomized controlled trials [RCTs]). Prophylactic azithromycin doesn't reduce hospitalizations overall (SOR: B, single small RCT).
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