Systemic and functional effects of continuous azithromycin treatment in patients with severe chronic obstructive pulmonary disease and frequent exacerbations

Background Continuous treatment with azithromycin may lead to fewer acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but little is known its impact on systemic and functional outcomes in real-life settings. Methods This was a multicenter prospective observational study patients severe COPD who started azithromycin. Tests were compared at baseline after 3 12 months treatment. These included lung function tests, 6-min walking test (6MWT), enzyme-linked immunosorbent assays serum sputum markers, such as interleukins (IL-6, IL-8, IL-13, IL-5), tumor necrosis factor receptor 2 (TNFR2), inflammatory markers. Incidence rate ratios (IRR) their 95% confidence intervals (95% CI) are reported. Results Of the 478 eligible patients, 42 experienced reductions AECOPDs (IRR, 0.34; CI, 0.26–0.45) hospitalizations 0.39; 0.28–0.49). Treatment also associated significant improvement partial arterial pressure oxygen (9.2 mmHg, CI 1.4–16.9) months. While TNFR2 reduced significantly both samples, IL-13 IL-6 only samples. Moreover, an elevated IL-8 level predicted good clinical response Conclusion cohort frequent can reduce number severity improve gas exchange. changes pattern microorganism isolates decreases response. note, have utility predictor