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  1. Elizabeth Batalla-Duran
  1. Correspondence to Dr Elizabeth Batalla-Duran, Respiratory Medicine, Derriford Hospital, Plymouth PL6 8DH, UK; ebatalla-duran{at}nhs.net

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Azithromycin in asthma treatment

Azithromycin is being used in a variety of respiratory diseases for its anti-inflammatory effects as well as its antimicrobial properties. The AMAZES study (Gibson PG, et al. Lancet 2017;390:659–668) investigated whether azithromycin had any beneficial effects on asthma exacerbations and quality of life when added to standard therapy of inhaled corticosteroid and long-acting bronchodilators in patients with persistent symptomatic asthma. The randomised, double-blind placebo-controlled study allocated patients to receive azithromycin 500 mg (217 patients) or placebo (207 patients) three times a week for 48 weeks. Primary endpoints were the number of severe or moderate exacerbations (measured by need for increased corticosteroids, hospital visit, antibiotics or a reduction in asthma control questionnaire score) and asthma quality of life. Secondary endpoints were asthma control, nasal symptoms, cough, respiratory infections and sputum production. Azithromycin significantly reduced overall asthma exacerbations (1.07 per patient-year (95% CI 0.85 to 1.29) compared with placebo (1.86 per patient-year (1.54 to 2.18)). The incidence rate ratio was 0.59 (95% CI 0.47 to 0.74). Azithromycin also significantly reduced severe exacerbations compared with placebo (p=0.002). The proportion of …

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