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Azithromycin Helps Increase Bronchial Lumen Radius and Lumen Area in Patients with Severe Persistent Asthma

A study has revealed that patients with severe persistent asthma, treatment with azithromycin helps increase the bronchial lumen radius and lumen area. But, it seems to have not significant effect on wall thickness.

Azithromycin Helps Increase Bronchial Lumen Radius and Lumen Area in Patients with Severe Persistent Asthma
Photo: Doctor Diagnosing A Patient's Asthma Severity | InStyleHealth

What Is Severe Persistent Asthma?

A severe persistent asthma includes symptoms that persist throughout the day and night. Asthma can get in the way of daily activities and make it difficult to sleep especially nighttime symptoms often happen in people with severe asthma, thus, affecting the individual’s quality of life or QoL.

Based on the guidelines from the National Institutes of Health (NIH), severe persistent asthma has the following characteristics or features:

  • An FEV 1 measurement of less than 60% of usual (ages 5 and older)
  • Being woken up by symptoms, often 7 nights per week (ages 5 and older)
  • For ages 4 and younger, being woken up by symptoms on more than 1 night per week
  • Symptoms that occur throughout the day.
  • Symptoms that require short-acting beta 2-agonist therapy several times per day.
  • Symptoms that significantly limit a person’s regular activities and affects one's quality of life.

Severe persistent asthma can affect a person’s ability to perform regular daily task and may impede or affect the person’s quality of life or QoL. If an individual is not utilizing an effective treatment, symptoms can be devastating.

Occasionally, symptoms will happen throughout the day and during the night, forcing the person to stay awake.

Severe persistent asthma symptoms will vary in severity from minor inconveniences to life-threatening and debilitating attacks, during which symptoms can be aggravated.

What Is Azithromycin?

Azithromycin is a prescription drug. This medication is available in the following type or product:

  • An eye drop
  • An intravenous (IV) form which is administered by a healthcare provider
  • An oral suspension
  • An oral tablet

Azithromycin Oral Tablet - InStyleHealth
Photo: Azithromycin Oral Tablet | InStyleHealth

Azithromycin as an oral tablet is available as a generic drug as well as the branded drug such as Zithromax. The generic drugs usually cost less than the branded version. There are cases where these may not be available in all strengths or forms as the branded versions.

Azithromycin is a medication that is used to treat infections caused by certain bacteria. This medicine should not be used to treat infections caused by viruses, such as the common colds.

Azithromycin can be used in combination with other antibiotics when it is being used to treat infections such as mycobacterium avium complex and some sexually transmitted infections or STIs.

Azithromycin as a medication will stop bacteria from multiplying or reproducing. The medicine kills the bacteria and treats your bacterial infection.

Azithromycin oral tablet does not cause drowsiness; however, the drug can cause other side effects.

The more prevalent side effects of using azithromycin as an oral tablet can include the following:

  • Abdominal pain
  • Diarrhea
  • Headache
  • Nausea
  • Vomiting

If these effects are mild, these may go away within a few days or a couple of weeks. If the side effects are more severe or don’t go away, talk to a doctor.

There was a total of 90 patients with severe persistent asthma were randomized to receive azithromycin (250 mg, 2x a day, 3 days a week), prednisolone (5mg, 2x a day), or placebo for 8 months in addition to standard therapy.

Primary result was an improvement in right upper lobe apical segmental bronchus or RB1 wall thickness, which was measured with high resolution computed tomography. Secondary results were cough severity, dyspnea severity, asthma control test or ACT score, asthma exacerbation rate, pulmonary function tests, and fractional exhaled nitric oxide or FENO.

Among the patients, there were only 78 who completed 8 months of treatment of azithromycin (n=25), prednisolone (n=27), or placebo (n=26). Primary efficacy result was not met, with no marked changes found in bronchial wall thickness percentage across the treatment groups.

Although patients in the azithromycin and prednisolone groups revealed a significantly increased inner radius and lumen area.

Moreover, those patients who received azithromycin achieved meaningful improvements in dyspnea severity, ACT score, FENO, and spirometry measures, forced expiratory flow 25-75%, and FEV1/forced vital capacity.

The cough severity or asthma exacerbation rate persisted relatively the same even after 8 months of azithromycin treatment.


Source: Respir Med 2021;185:106494

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