Muhammad Usman Ullah, Raheel Iftikhar, Bar Khan M Babar, Amir Khalil, Jhanzaib Liaqat, Manzoor Qadir.
Role of Azithromycin for Prevention of COPD Exacerbations.
Pak J Chest Med Jan ;19(3):116-20.

OBJECTIVE: To determine the role of azithromycin in reducing frequency of exacerbations in patients with COPD. Design: Case control study. Place and duration of study: Department of pulmonology, Military Hospital Rawalpindi from Aug 2011 to Dec 2012. Methods: We included 290 patients in the study with clinical diagnosis of COPD exacerbation. One hundred and fifty patients were randomly assigned to receive azithromycin 250 mg thrice weekly for six months, 140 patients were given placebo. Detailed history, examination was documented on pre designed Proforma. Patients were reviewed monthly in out–patients department and inquired about number of exacerbations, compliance to therapy, and development of side effects. All the data was analyzed using SPSS version 16. Results: Risk of acute exacerbation was reduced in patients taking azithromycin ( p value 0.005). Mean time to first exacerbation of COPD was 155 days (± 25.4) in patients receiving azithromycin as compared to 110 days (±19.3) in placebo group (p value 0.03).Total of 320 episodes of acute COPD exacerbation occurred during study, 77 among patients in azithromycin group as compared to 243 among control group(p value 0.002). The number needed to prevent one acute exacerbation of COPD 2.53. Conclusion: Azithromycin given thrice weekly for six months in patients of COPD resulted in significant reduction in number of exacerbations and time to develop first exacerbation.

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