Exacerbations in patients with chronic obstructive pulmonar disease (COPD) were proven to be significantly reduced when continuous prophylaxis antibiotic with a macrolide was used, a team of researchers from Canada and New Zealand found.

Researchers reviewed several randomized clinical trials in order to discover whether prophylactic antibiotic treatment is associated with fewer exacerbations or improved health-related quality of life (HRQOL) in patients with COPD.

Of seven eligible studies, five assessed continuous antibiotic prophylaxis with a macrolide over 1 to 12 months, including azithromycin, clarithromycin and erythromycin. As a result, researchers associated continuous and pulsed antibiotics with fewer exacerbations over 6 to 12 months and improved HRQOL. The team stressed, however, that this was not clinically significant.

Researchers also pointed out the problems of antibiotic resistance stemming from long-term antibiotic use, as well as the potential for adverse events. For this reason, they wrote, quoted by Infectious Disease News, this review “supports cautious use of continuous macrolide prophylaxis with close monitoring for patients with frequent infective COPD exacerbations after other standard therapies have been prescribed.”