CFDB - Cystic Fibrosis DataBase

primary studies published RCT

Daily versus weekly azithromycin in cystic fibrosis patients.

Study design (if review, criteria of inclusion for studies)

Multicentre parallel RCT comparing 2 dosing regimens (daily versus weekly) of azithromycin.

Participants

208 CF patients (6-58 years).

Interventions

250 mg daily versus 1200 mg weekly doses of azithromycin.

Outcome measures

Change in FEV1 (%) at 1,3 and 6 months from baseline. Also time to PEx, adverse effects, days in hospital, QoL, changes in inflammatory markers, acquisition of azithromycin resistant S. aureus.

Main results

Equivalence was demonstrated between the two groups (daily versus weekly) with respect to improvements in lung function (forced expiratory volume in one second and forced vital capacity), C-reactive protein, days spent in hospital, admission rates and nutrition (body mass index, z-scores) using 95% confidence intervals with a tolerance interval of +/-10%. In patients aged <18 yrs the daily group had significantly better improvements in z-scores for height and weight after 6 months. In children, a nutritional advantage for daily administration was found. Gastro-intestinal adverse effects were more common with weekly therapy.

Authors' conclusions

Apart from these findings, daily and weekly administered azithromycin demonstrated similar outcomes for cystic fibrosis patients.

Keywords: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Bacterial Infections; Child; Drug Administration Schedule; Infection; pharmacological_intervention; Pneumonia; Respiratory Tract Diseases; Respiratory Tract Infections; Macrolides; Anti-Inflammatory Agents; Anti-Inflammatory Agents - excl Steroids;