Prophylactic antibiotic therapy effective for chronic obstructive pulmonary disease

Use of prophylactic macrolide antibiotics for a period of up to 12 months reduced the number of patients with 1 or more exacerbations (number needed to treat to benefit = 8). Prophylactic antibiotics also reduced exacerbation frequency, increased the median time to first exacerbation and improved health‐related quality of life. Benefits appeared to be driven by continuous and intermittent macrolide regimens, with pulsed regimens being less effective. Use of antibiotics did not significantly affect the number of deaths due to any cause, the frequency of hospitalisation or loss of lung function during the study period. The antibiotics investigated were azithromycin, erythromycin, clarithromycin, roxithromycin, doxycycline and moxifloxacin. On average, the people involved in the studies were 65 to 72 years old and had moderate or severe COPD.