#Azithromycin for Acute Exacerbations of #Asthma
The AZALEA Randomized Clinical Trial
http://archinte.jamanetwork.com/mobile/article.aspx?articleid=2553295
Conclusions and Relevance In this randomized population, azithromycin treatment resulted in no statistically or clinically significant benefit. For each patient randomized, more than 10 were excluded because they had already received antibiotics.
The AZALEA Randomized Clinical Trial
http://archinte.jamanetwork.com/mobile/article.aspx?articleid=2553295
Conclusions and Relevance In this randomized population, azithromycin treatment resulted in no statistically or clinically significant benefit. For each patient randomized, more than 10 were excluded because they had already received antibiotics.
Jamanetwork
Azithromycin for Acute Exacerbations of Asthma
This randomized clinical trial examines whether azithromycin added to standard care for asthma attacks in adults results in clinical benefit.
Effect of #azithromycin on #asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31281-3/fulltext
Exacerbations of asthma cause a substantial global illness burden. Adults with uncontrolled persistent asthma despite maintenance treatment require additional therapy. Since macrolide antibiotics can be used to treat persistent asthma, we aimed to assess the efficacy and safety of oral azithromycin as add-on therapy in patients with uncontrolled persistent asthma on medium-to-high dose inhaled corticosteroids plus a long-acting bronchodilator.
Patients were randomly assigned (1:1) to receive azithromycin 500 mg or placebo three times per week for 48 weeks The proportion of patients experiencing at least one asthma exacerbation was reduced by azithromycin treatment (127 [61%] patients in the placebo group vs 94 [44%] patients in the azithromycin group, p<0·0001). Azithromycin significantly improved asthma-related quality of life (adjusted mean difference, 0·36 [95% CI 0·21–0·52]; p=0·001). Diarrhoea was more common in azithromycin-treated patients (72 [34%] vs 39 [19%]; p=0·001).
Interpretation
Adults with persistent symptomatic asthma experience fewer asthma exacerbations and improved quality of life when treated with oral azithromycin for 48 weeks. Azithromycin might be a useful add-on therapy in persistent asthma.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31281-3/fulltext
Exacerbations of asthma cause a substantial global illness burden. Adults with uncontrolled persistent asthma despite maintenance treatment require additional therapy. Since macrolide antibiotics can be used to treat persistent asthma, we aimed to assess the efficacy and safety of oral azithromycin as add-on therapy in patients with uncontrolled persistent asthma on medium-to-high dose inhaled corticosteroids plus a long-acting bronchodilator.
Patients were randomly assigned (1:1) to receive azithromycin 500 mg or placebo three times per week for 48 weeks The proportion of patients experiencing at least one asthma exacerbation was reduced by azithromycin treatment (127 [61%] patients in the placebo group vs 94 [44%] patients in the azithromycin group, p<0·0001). Azithromycin significantly improved asthma-related quality of life (adjusted mean difference, 0·36 [95% CI 0·21–0·52]; p=0·001). Diarrhoea was more common in azithromycin-treated patients (72 [34%] vs 39 [19%]; p=0·001).
Interpretation
Adults with persistent symptomatic asthma experience fewer asthma exacerbations and improved quality of life when treated with oral azithromycin for 48 weeks. Azithromycin might be a useful add-on therapy in persistent asthma.
The Lancet
Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised…
Adults with persistent symptomatic asthma experience fewer asthma exacerbations and
improved quality of life when treated with oral azithromycin for 48 weeks. Azithromycin
might be a useful add-on therapy in persistent asthma.
improved quality of life when treated with oral azithromycin for 48 weeks. Azithromycin
might be a useful add-on therapy in persistent asthma.
!!
Update – CDC Recommendations for Managing and Reporting #Shigella Infections with Possible Reduced Susceptibility to #Ciprofloxacin
https://emergency.cdc.gov/han/han00411.asp
..If antibiotic treatment is necessary, monitor patients carefully.
If you identify or receive a report of a patient with Shigella infection and possible fluoroquinolone or #azithromycin treatment failure:
Consider consulting an infectious disease specialist to identify other treatment options, because some Shigella isolates with susceptible ciprofloxacin MICs may harbor one or more quinolone resistance mechanisms.
Contact your local health department to coordinate reporting treatment failure information. This information should be reported to CDC at EntericBacteria@cdc.gov.
Collect a stool specimen for culture, and work with your clinical microbiology laboratory to submit for additional antimicrobial susceptibility testing.
Request that your laboratory expedite submission of the Shigella isolate to your state public health laboratory. Your state laboratory should notify CDC at EntericBacteria@cdc.gov to coordinate additional laboratory testing and/or shipment of the isolate to CDC.
Update – CDC Recommendations for Managing and Reporting #Shigella Infections with Possible Reduced Susceptibility to #Ciprofloxacin
https://emergency.cdc.gov/han/han00411.asp
..If antibiotic treatment is necessary, monitor patients carefully.
If you identify or receive a report of a patient with Shigella infection and possible fluoroquinolone or #azithromycin treatment failure:
Consider consulting an infectious disease specialist to identify other treatment options, because some Shigella isolates with susceptible ciprofloxacin MICs may harbor one or more quinolone resistance mechanisms.
Contact your local health department to coordinate reporting treatment failure information. This information should be reported to CDC at EntericBacteria@cdc.gov.
Collect a stool specimen for culture, and work with your clinical microbiology laboratory to submit for additional antimicrobial susceptibility testing.
Request that your laboratory expedite submission of the Shigella isolate to your state public health laboratory. Your state laboratory should notify CDC at EntericBacteria@cdc.gov to coordinate additional laboratory testing and/or shipment of the isolate to CDC.