Azithromycin and bronchiolitis obliterans syndrome after lung transplantation: is prevention better than cure?

A lthough lung transplantation is now accepted as an established therapy for selected patients with end-stage lung disease, long-term survival after lung transplantation remains limited by the development of bronchiolitis obliterans syndrome (BOS) in .50% of recipients [1]. BOS is the clinical manifestation of an inflammatory bronchiolitis associated with fibrotic remodelling of the small and mediumsized airways, and is characterised by progressive loss of allograft function with development of airflow obstruction [2, 3].