Hard-to-treat asthma can be a life-threatening lung disease. That’s why new research from Australia suggesting that the antibiotic azithromycin (Zithromax) for asthma is so exciting. The authors called their trial AMAZES (Asthma and Macrolides: AZithromycin Efficacy and Safety study). Asthma was once considered a serious but not life-threatening lung condition. William Osler, MD, has been described as the father of modern medicine. He described the “asthmatic panting into old age.” About 300 million people around the world have asthma, a chronic inflammation of the airways that causes wheezing and difficulty breathing. He was one of the founders of Johns Hopkins Medical School. (According to the American Lung Association and the CDC, the current figure in the US is 26 million children and adults with asthma.) Thousands die each year and the financial costs top $50 billion. Such statistics do not capture the personal toll that asthma takes. Some people curtail their activities in an attempt to avoid attacks. Others end up in the emergency room in acute distress, gasping for breath. Some health professionals suggest that the reason for so many asthma deaths is that patients are “noncompliant.” We find that concept objectionable. , it found that azithromycin add-on therapy reduces exacerbation frequency and improves quality of life in asthmatic patients. There is currently a strong need to prevent asthma exacerbation in patients with uncontrolled asthma. Many new biological medications have come on the market recently to treat this segment of the population. All of them come with a heavy price tag and may not be feasible for all patients with severe persistent asthma. New Asthma Drug Nucala (Mepolizumab) for Severe Eosinophilic Asthma Cinqair (Reslizumab) for Eosinophil Disorders (formerly Cinquil) Fasenra (Benralizumab) for Severe Asthma A randomized trial looked at adding the antibiotic azithromycin (this antibiotic is commonly known as Z-pack) for patients with severe asthma that was uncontrolled by inhaled corticosteroids and long acting bronchodilators. They were either assigned to receive 500mg of azithromycin 3 times per week or a placebo for 48 weeks. Azithromycin treatment decreased the frequency of all asthma exacerbations and severe exacerbations.
During this almost two week period, I was able to cut my inhaled steroid dosage in half, and I wheezed and coughed less. This discovery motivated me to search the web for keywords "asthma" and "azithromycin" (azithromycin is the generic name of Zithromax, which is sold exclusively by Pfizer in the U. S.: I presented some of the research that Jim Quinlan has assembled (Asthma cure research page from asthmastory.com) to two physicians (both Internists, one my physician, the other my brother-in-law) who both said that this treatment would not improve my asthma. 4 puffs twice daily of the strongest 220 mcg Flovent (the absolute maximum recommended dosage), 2 puffs twice daily of Serevent, Singulair once daily, albuterol inhaler as needed, theophylline as needed, and an occasional nebulizer treatment with albuterol. Over the years that I had been taking inhaled steroids (e.g., Flovent), I kept increasing the dosage as the asthma seemed to get worse and worse, until I finally reached the absolute maximum recommended dosage. After six weeks of this, my asthma was so much better that I was able to completely stop my Flovent, Serevent, and Singulair, and I only needed to take an albuterol inhaler occasionally (less than one puff per week). Even if your asthma is worsened by a persistent bacterial infection, you may need to pursue a treatment that involves antibiotic(s) other than azithromycin, and the treatment may last longer than nine to fifteen weeks. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial. Does the routine use of antibiotics reduce the frequency of exacerbations? What more can patients and clinicians do to reduce the risk of exacerbations? This is the question the recently published AMAZES study attempted to answer. Asthma exacerbations are often triggered by allergens or viral infections, and far less frequently by bacteria. Macrolide antibiotics have been shown to improve asthma symptoms, but previous systematic reviews have been inconclusive or did not examine exacerbation frequency as the primary endpoint. Given their theoretical anti-inflammatory, antiviral, and antibacterial properties, macrolide antibiotics may be useful in both eosinophilic and non-eosinophilic asthma phenotypes; the latter is generally insensitive to inhaled corticosteroids and adjunctive treatments like omalizumab. The Global Initiative for Asthma Guideline recommends against the use of antibiotics for the acute treatment of asthma exacerbations unless there is strong evidence of a bacterial infection.
Introduction. There is interest in the use of macrolide antibiotics in asthma. Macrolides have been shown to improve airway hyper-responsiveness AHR and. The antibiotic is called azithromycin and goes by several brand names such as. This antibiotic is not a pbs approved medication for asthma, however it can be.