The effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial
Background Chronic cough is a common clinical problem worldwide. Although many patients have underlying precipitating conditions such as asthma, gastroesophageal reflux, or rhinitis, many remain symptomatic despite treating these conditions. New approaches are needed for the treatment of this gro...
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| Format: | Article |
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Elsevier
2016
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| Online Access: | https://eprints.nottingham.ac.uk/42609/ |
| _version_ | 1848796526048968704 |
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| author | Hodgson, David Anderson, John Reynolds, Catherine Oborne, Janet Meakin, Garry Bailey, Helen Shaw, Dominick E. Mortimer, Kevin Harrison, Tim |
| author_facet | Hodgson, David Anderson, John Reynolds, Catherine Oborne, Janet Meakin, Garry Bailey, Helen Shaw, Dominick E. Mortimer, Kevin Harrison, Tim |
| author_sort | Hodgson, David |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
Chronic cough is a common clinical problem worldwide. Although many patients have underlying precipitating conditions such as asthma, gastroesophageal reflux, or rhinitis, many remain symptomatic despite treating these conditions. New approaches are needed for the treatment of this group of patients.
Methods
We conducted a randomized, double-blind, placebo-controlled trial to determine whether 250 mg of azithromycin three times a week for 8 weeks would affect the Leicester Cough Questionnaire (LCQ) score in 44 patients with treatment-resistant cough. Cough severity on a visual analog scale and bronchial exhaled nitric oxide were measured as secondary outcomes.
Results
There was a clinically important improvement in LCQ score with azithromycin (mean change, 2.4; 95% CI, 0.5 to 4.2) but not placebo (mean change, 0.7; 95% CI, −0.6 to 1.9), but the between-group difference was not statistically significant (P = .12). There were no significant between-group differences for any of the secondary outcome measures. Looking at subgroups of responders, there was a large and significant improvement in LCQ score in patients with chronic cough and a concurrent diagnosis of asthma who were treated with azithromycin (mean, 6.19; 95% CI, 4.06 to 8.32).
Conclusions
Treatment with low-dose azithromycin for 8 weeks did not significantly improve LCQ score compared with placebo. The use of macrolides for treatment-resistant cough cannot be recommended from this study, but they may have a place in the treatment of chronic cough associated with asthma; this is worthy of further investigation. |
| first_indexed | 2025-11-14T19:49:23Z |
| format | Article |
| id | nottingham-42609 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:49:23Z |
| publishDate | 2016 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-426092020-04-29T15:22:50Z https://eprints.nottingham.ac.uk/42609/ The effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial Hodgson, David Anderson, John Reynolds, Catherine Oborne, Janet Meakin, Garry Bailey, Helen Shaw, Dominick E. Mortimer, Kevin Harrison, Tim Background Chronic cough is a common clinical problem worldwide. Although many patients have underlying precipitating conditions such as asthma, gastroesophageal reflux, or rhinitis, many remain symptomatic despite treating these conditions. New approaches are needed for the treatment of this group of patients. Methods We conducted a randomized, double-blind, placebo-controlled trial to determine whether 250 mg of azithromycin three times a week for 8 weeks would affect the Leicester Cough Questionnaire (LCQ) score in 44 patients with treatment-resistant cough. Cough severity on a visual analog scale and bronchial exhaled nitric oxide were measured as secondary outcomes. Results There was a clinically important improvement in LCQ score with azithromycin (mean change, 2.4; 95% CI, 0.5 to 4.2) but not placebo (mean change, 0.7; 95% CI, −0.6 to 1.9), but the between-group difference was not statistically significant (P = .12). There were no significant between-group differences for any of the secondary outcome measures. Looking at subgroups of responders, there was a large and significant improvement in LCQ score in patients with chronic cough and a concurrent diagnosis of asthma who were treated with azithromycin (mean, 6.19; 95% CI, 4.06 to 8.32). Conclusions Treatment with low-dose azithromycin for 8 weeks did not significantly improve LCQ score compared with placebo. The use of macrolides for treatment-resistant cough cannot be recommended from this study, but they may have a place in the treatment of chronic cough associated with asthma; this is worthy of further investigation. Elsevier 2016-04-30 Article NonPeerReviewed Hodgson, David, Anderson, John, Reynolds, Catherine, Oborne, Janet, Meakin, Garry, Bailey, Helen, Shaw, Dominick E., Mortimer, Kevin and Harrison, Tim (2016) The effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial. Chest, 149 (4). pp. 1052-1060. ISSN 1931-3543 Airway inflammation; Antibiotic therapy; Cough https://doi.org/10.1016/j.chest.2015.12.036 doi:10.1016/j.chest.2015.12.036 doi:10.1016/j.chest.2015.12.036 |
| spellingShingle | Airway inflammation; Antibiotic therapy; Cough Hodgson, David Anderson, John Reynolds, Catherine Oborne, Janet Meakin, Garry Bailey, Helen Shaw, Dominick E. Mortimer, Kevin Harrison, Tim The effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial |
| title | The effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial |
| title_full | The effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial |
| title_fullStr | The effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial |
| title_full_unstemmed | The effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial |
| title_short | The effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial |
| title_sort | effects of azithromycin in treatment-resistant cough: a randomized, double-blind, placebo-controlled trial |
| topic | Airway inflammation; Antibiotic therapy; Cough |
| url | https://eprints.nottingham.ac.uk/42609/ https://eprints.nottingham.ac.uk/42609/ https://eprints.nottingham.ac.uk/42609/ |