The adverse effects of azithromycin on the treatment of patients with chronic lung

23 The adverse effects of azithromycin on the treatment of patients with chronic lung 24 diseases (CLD) were evaluated in the present study. 25 MEDLINE, and other databases were searched for relevant articles till August 2013. 26 Randomized controlled trials enrolled patients with chronic lung diseases who 27 received long-term azithromycin treatment were selected and data on microbiological 28 study and azithromycin-related adverse events were abstracted from articles and 29 analyzed. 30 Six studies were included in the meta-analysis. The risk of bacteria resistance in 31 patients receiving long-term azithromycin treatment was increased 2.7-fold [RR: 2.69 32 (95% CI 1.249, 5.211)] when compared with patients with placebo treatment. On the 33 opposite, the risk of bacteria colonization in patients receiving azithromycin treatment 34 decreased [RR: 0.551 (95% CI 0.460, 0.658)]. Patients with long-term azithromycin 35 therapy were at risk of increased impairment of hearing [RR: 1.168 (95% CI 1.030, 36 1.325)]. 37 This analysis provides evidence that supports the development of bacteria resistance 38 after receiving long-term azithromycin treatment. Besides the increasingly recognized 39 anti-inflammatory role of azithromycin used in chronic lung diseases, we should be 40 realized the potential adverse event of its long-term use. 41