In a clinical trial, adding the antibiotic azithromycin to standard treatment for asthma exacerbations in adults had no significant therapeutic benefit.

Findings were consistently negative across different symptom and quality-of-life scores, and treatment with the antibiotic also had no measurable impact on lung function, including FEV1, wrote researcher Sebastian L. Johnston, PhD, of the Imperial College London, and colleagues in JAMA Internal Medicine, published online Sept. 19.

The negative findings contrast with the TELICAST study, also reported by Johnston and colleagues, which demonstrated a positive clinical benefit for another macrolide antibiotic — telithromycin — for asthma exacerbations. Severe adverse reactions — especially liver toxicity — limit the use of this drug to patients with life-threatening infections.

Treatment guidelines, included those recently published by the Global Initiative for Asthma (GINA), do not recommend routine antibiotic use for asthma exacerbations. Yet, in the current trial, the investigators had to exclude nearly half of those screened because they had recently received antibiotics.

The Azithromycin Against Placebo in Exacerbations of Asthma (AZALEA) study was conducted to examine the activity of the semisynthetic macrolide antibiotic azithromycin on asthma exacerbations.

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