Azithromycin Better at Preventing Bronchiectasis Worsening Than Other Antiobiotics, Study Reports

Azithromycin Better at Preventing Bronchiectasis Worsening Than Other Antiobiotics, Study Reports

A retrospective study comparing the effects of different antibiotics in preventing bronchiectasis exacerbations demonstrated the superior effectiveness of azithromycin, compared to other antibiotics from the same class, including erythromycin and roxithromycin.

The Chinese study, “Azithromycin or erythromycin? Macrolides for non-cystic fibrosis bronchiectasis in adults: a systematic review and adjusted indirect treatment comparison,” was published in the Chronic Respiratory Disease journal.

Between 2000 and 2007, bronchiectasis morbidity in the U.S. was 1,106 cases per 100,000 people, with an annual increase of 8.74 percent.

A number of treatments are prescribed to manage the disease, including antibiotics. These are used to prevent the worsening of symptoms, or exacerbation, and to reduce the number of bacteria in the lungs.

This is the case of macrolides, a class of antibiotics that are not only antibacterial but also have immune-regulatory effects. Azithromycin, erythromycin, and roxithromycin belong to the macrolides group and are sold under several brand names.

Due to the broad range of macrolides, physicians pose the question, “Which kind of macrolide antibiotic is more effective and safe in preventing bronchiectasis exacerbation?”

To find the answer, a research team from Guiyang University of Chinese Medicine in Guiyang, China, studied clinical trials published until May 2017 that reported the use of macrolides in patients with non-cystic fibrosis bronchiectasis, and compared the results in terms of safety and efficacy.

The team analyzed data collected from seven studies enrolling 457 participants.

Researchers found that macrolides, in general, decreased the rate and number of bronchiectasis exacerbations, measured as the number of exacerbations per patient and per year, respectively.

A more detailed analysis revealed that azithromycin and erythromycin, but not roxithromycin, significantly decreased the number of disease exacerbations. Azithromycin was actually more effective as it induced a significantly lower exacerbation rate than erythromycin, demonstrating the superior effectiveness of the drug in preventing exacerbations.

Diarrhea, nausea, and other gastrointestinal reactions are known common adverse events of macrolides. Azithromycin increased the risk of diarrhea and abnormal pain, compared to placebo treatments and other macrolides.

Overall, the study demonstrated azithromycin’s superior capacity to decrease bronchiectasis exacerbations, and can eventually help physicians deciding which antibiotic to prescribe.

“This meta-analysis suggested that long-term treatment with macrolides significantly reduced the incidence of non-cystic fibrosis (CF) bronchiectasis exacerbation,” the researchers wrote, adding that “indirect treatment comparisons showed that azithromycin is more efficient than roxithromycin and erythromycin in preventing non-CF from exacerbation.”


  1. Dr Hannah S Wilder says:

    Please include an article on the use of ozone in treating bronchiectasis. I have seen at least one anecdotal video in which patient was given treatments of ozone filtered through eucalyptus and pine oil, which made ozone non irritating. The patient, who had had recurrent infections, stopped having them altogether. I hope you will feature such treatments that do not necessarily generate large incomes for pharmaceutical treatments.

    • Virginia Beck, NP says:

      Thanks for including this comment, I also use a diffuser with essential oils because my office is air conditioned.

      the use of the MoleKule air filter helps significantly . It is pricy but effective.

  2. Beatrice Muchman says:

    Thank you for this information. My doctor has been recommneding azithromycin
    for a long time during flare up episodes due to colds or coughs.

  3. Glenda says:

    I have today had a telephone consultation re my increased mucus production which is now occasionally blood streaked or pinky. Consultant has agreed it’s okay for me to go back on Azithromycin (3 times a week) which I gave up for the summer. Feeling safer.

    • John Chase Lee says:

      Re increased mucus production:
      My wife who had “non-CF Bronchiectasis” was able to stop her coughing, including the exacerbation(spasm), by taking the dietary supplement, “Triple Burn”, of Dr. Al Sears. Triple Burn is supposed to be good for 619 diseases. After taking the supplement pills twice a day for several days, she stopped miraculously her mucus and coughing problems completely. We wish we had known to use the supplement much earlier than three months before her passing. Her passing in May this year, I believe, was largely due to her starvation, due to the loss of her appetite. We did not know how to stop her losing weight steadily from 105 lbs to 60 lbs. Our pulmonologist Dr. warned us that she must not go down below 80 lbs. Recently, I began to regret deeply that we did not try “hypnosis” to lead her to eat as soon as she began to lose weight.

  4. jaime manriquez says:

    thanks john chase for your post, sorry about your lost, I have the acute Bronchiectasis an my problem is the excess of productive couhg, specially at nites when i lie down to sleep, waking me up several times, so Will be very helpful to know more about “triple Burn..Dr. Al Sears

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