Long-Term Antibiotic May Reduce COPD Problems
At 1-Year Mark, Azithromycin Reduced COPD Flare-ups
Antibiotics for COPD: Study Details continued...
During the study, there were 156 hospitalizations for COPD for the antibiotic group and 200 for the placebo group.
The antibiotic is available generically, Dransfield says. It costs about a dollar a pill.
The regimen had downsides, he tells WebMD. One was hearing loss, which has been found with other antibiotics as well, he says. "We did see a small percent of people with hearing loss, but the differences between drug and placebo was not dramatic," he says. Although 25% of those on medication had a hearing decline when tested, 20% of those on placebo did.
The medicine also increased the amount of antibiotic-resistant microbes in some patients. However, no one got an infection related to that during the study.
Dransfield says the regimen would only be meant for those with moderate to severe COPD who require supplemental oxygen or who have a history of flare-ups.
''If you are in the ER a couple times a year or the hospital once a year and have frequent flare-ups, more than twice a year, I think the benefits outweigh the risks here," he says.
Patients who have heart problems linked with abnormal rhythms are not good candidates for the long-term therapy, he says.
Dransfield reports consulting and speaking fees for GlaxoSmithKline, Boehringer Ingelheim, and Forest Pharmaceuticals.
Antibiotics for COPD: Perspective
''It looks like it reduces exacerbations of COPD, and that is a good thing," says Norman Edelman, MD, chief medical officer for the American Lung Association, He reviewed the study findings but was not involved in the research. He is also professor of preventive and internal medicine at Stony Brook School of Medicine.
The fewer the flare-ups, he says, the fewer hospitalizations, and the better the quality of life.
In general, ''the more exacerbations, the more rapidly the underlying severity of the disease progresses,'' Edelman says.
However, he had some caveats about the research. "One is the hearing issue," he says.
The other issue is finding out how much you are changing the microbe population of the lung long-term, Edelman says. That could lead to antibiotic resistance.
For now, his best advice for COPD patients who think the new treatment would help is to talk to their doctor. "Make sure he has read the study," Edelman says.