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Macrolide antibiotics have antibacterial, antiviral, and anti-inflammatory effects and thus have generated interest for treating patients with asthma. Australian researchers evaluated azithromycin as add-on therapy in a randomized trial that involved 420 adults (median age, 60) with asthma not controlled with inhaled corticosteroids and long-acting bronchodilators. Participants received azithromycin (500 mg) or placebo thrice weekly for 48 weeks.
Azithromycin patients had significantly fewer moderate or severe exacerbations than did placebo patients (1.07 vs. 1.86 per person-year). Fewer exacerbations were seen for both eosinophilic and neutrophilic asthma, and fewer azithromycin patients had at least one exacerbation (44% vs. 61%). Asthma-r…