Tag Archives: COPD

Azithromycin helps prevent COPD set-back episodes

A study outlining the use of weekly azithromycin for COPD patients with frequent exacerbations was published recently in the world’s leading general medical journal, Lancet. “Frequent” was defined as three or more episodes in a year of these episodes of sustained worsening of these patients’ conditions.

Several cogent reasons warrant attempting to prevent these exacerbations. First and foremost, they make the patient sick and can lead to hospitalization, and sometimes to death. Also, each exacerbation can worsen the overall degree of lung impairment, kind of a racheting down in lung function. The patients in the year-long Lancet study were treated with 500 mg. a day of azithromycin for the first three days of each week.

This particular drug was chosen because it has immunomodulatory properties. That is, it works not only as an antimicrobial, but also as an anti-inflammatory. It is concentrated 200 times in the white blood cells, which go to the bronchial tissues. It also has a long half-life of about 70 hours after a dose.

Patients in the trial had 58 percent fewer exacerbations.  Additionally, this benefit lasted for more than six months after the drug was stopped.

Effective therapy; no increased risk with asthma

Inhaled corticosteroids are an important therapy for a variety of lung conditions, especially Chronic Obstructive Pulmonary Disease (COPD) and asthma.

It has been known for several years that inhaled steroids increase the risk of pneumonia in patients with COPD. Whether this is also true in asthmatics has not been studied.

A recent research paper in the Journal of Respiratory and Critical Care Medicine indicates that inhaled steroids do not raise the risk for pneumonia in asthmatics. In the cited clinical trial involving 15,000 children and adults with asthma there was no increased risk for pneumonia.

A second study looked at low-dose versus higher-dose inhaled steroids in asthmatics and there was no increase in risk in the high-dose group.