Comparison between azithromycin and roxithromycin in preventing the acute exacerbation of chronic obstructive pulmonarydisease and its adverse reaction

Objective To compare azithromycin and roxithromycin in preventing the acute exacerbation of chronic obstructive pulmonary disease (COPD) and its adverse reaction. Methods We performed a controlled trial, patients with COPD who were treated in the outpatient clinic were randomly divided into azithromycin group, roxithromycin group and control group, followed up for 12 months.The number of acute attacks and changes in lung function were observed in the three groups.The quality of life was assessed using the St.George′s respiratory questionnaire (SGRQ), and the adverse reactions of the two groups were collected to compare the efficacy and safety of roxithromycin and azithromycin. Results In the end, 162 people entered the study, including 49 in the azithromycin group, 55 in the roxithromycin group, and 58 in the control group.The 12-month follow-up was completed.The number of acute exacerbations in the azithromycin group was (1.39±0.95) times/person/year, and the number of acute exacerbations in the roxithromycin group was (1.47±0.84) times/person/year, which were less than the control group (1.81±0.95) times/person/year (P<0.05). The SGRQ score for the azithromycin group decreased (-3.76±4.52) and the roxithromycin group decreased (-1.35±6.56) and the control group decreased (-0.05±5.41). The difference is statistically significant (P<0.05). Multiple regression showed that acute episodes are not associated with gender, age, and inhaled drug regimenns, but negatively correlated with forced expiratory volume in one second and oral macrolide antibiotics (P<0.05). The incidence of gastrointestinal discomfort in azithromycin and roxithromycin group was statistically significant (46.0% vs 17.5%). The difference is statistically significant (P<0.05). Conclusions In the prevention of acute exacerbations of COPD, conventional inhalation therapy combined with low-dose roxithromycin can achieve azithromycin-like effects, while the incident of gastrointestinal discomfort was low. Key words: Azithromycin; Roxithromycin; Chronic obstructive pulmonary disease; Acute exacerbation; Adverse reaction