A retrospective analysis of the impact of azithromycin maintenance therapy on adults attending a UK cystic fibrosis clinic

Background: Azithromycin is widely used as an immunomodulatory agent in the treatment of cystic fibrosis with previous literature documenting improvements in lung function and a reduction in infective exacerbations. The maximal study period in adults has been six months. Methods: 81 adult patients taking continuous azithromycin were retrospectively identified. Percentage predicted FEV1 and courses of intravenous antibiotics were examined at yearly intervals two years prior to and two years after azithromycin initiation. Results: FEV1 deteriorated in the two years before starting azithromycin by a mean of 2.02% per year. In the year following initiation, FEV1 increased by 1.15% (P=0.01). However, a mean 2.58% reduction was observed in year two. There was no statistically significant effect on courses of intravenous antibiotics. Conclusions: Azithromycin resulted in an improved FEV1 at year one. This effect was not sustained beyond the first year of treatment. (C) 2012 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.