Abstract
Introduction: Macrolides are used in the management of non-cystic fibrosis bronchiectasis (NCFB). Recent trials have looked at their impact over 12 months although patients are often on these drugs for longer. A recent sub-group analysis suggested that Erythromycin may displace Haemophilus influenzae allowing an increase in pathogens such as Pseudomonas aeruginosa (Pa).
Study Aim: To compare the number of new isolates of Pa in patients with NCFB using Azithromycin (AZI) and those who are AZI naive.
Method: A retrospective review was performed. Patients were excluded if they had insufficient datasets, had started AZI within the last two years or had commenced but ceased AZI within 2 years. In those who had received AZI, sputum results were recorded for 12 months before commencing the drug and for the following 24 months. For AZI naïve patients, sputum results were recorded for a defined 36 month period.
Results: Of 343 patients reviewed, 105 were excluded. In the remaining 238 patients, (mean age 67 years, 67% female), 106 had received AZI for at least 2 years. For patients whose sputum had not isolated Pa in the year before (n=205), 16/80 grew it in the subsequent 2 years if taking AZI compared with 14/125 in the non-AZI group (p=0.082). In the AZI group, 59 patients had at least one sputum sample in each recorded year, with no significant difference in the percentage of patients isolating Pa in each year studied (See table).
Yr 1 | Yr 2 | Yr 3 | |
AZI | 27% | 27% | 25% |
AZI naive | 14% | 20% | 25% |
Conclusion: Observation of our cohort's sputum sample results did not demonstrate a significant increase in Pa in association with AZI use.
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