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Antibiotic fails to improve lung function in children with CF

Azithromycin does not improve lung function but has other benefits

OnMedica staff

Wednesday, 05 May 2010

Children and adolescents with cystic fibrosis (CF) who take azithromycin do not have improved lung function compared with those on placebo, but the drug may have other benefits, according to a study in this week’s Journal of the American Medical Association.

Azithromycin, which has both anti-inflammatory and antimicrobial properties, has appeared to be of benefit to people with CF. It is recommended for those with Pseudomonas aeruginosa infection but there has been insufficient evidence for its use in other CF patients, so researchers conducted a randomised, placebo-controlled trial to see whether azithromycin improved lung function or reduced pulmonary exacerbations.

They randomised 260 children and adolescents with CF, who were uninfected with P. aeruginosa, to either azithromycin or placebo. The average age of the participants was 10.7 years.

Treatment with azithromycin for 24 weeks, compared with placebo, did not lead to an improvement in pulmonary function, as measured by the change in FEV1 (forced expiratory volume in 1s). Nor were there differences between the groups in terms of their use of intravenous or inhaled antibiotics, or hospitalisations.

But the researchers found that the drug had other benefits for treated children: “When compared with the placebo group, the azithromycin group had a 50% reduction in pulmonary exacerbations, 27% reduction in the initiation of new oral antibiotics (other than azithromycin), 1.3lbs [0.6kg] weight gain, and 0.34-unit increase in body mass index.”

Participants in the azithromycin group also had less cough and less productive cough, compared with placebo participants.

“Further studies of azithromycin are warranted to further investigate its potential use in this population,” the researchers conclude.

JAMA 2010;303[17]:1707-15.

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