Comparing the Effects of Oral Azithromycin with Standard Treatment in Patients with Chronic Obstructive Pulmonary Disease: A Double-Blind Randomized Controlled Trial

Background and aims: Data regarding the use of macrolide antibiotics in patients with chronic obstructive pulmonary disease (COPD) are limited and inconsistent. The objective of this study was to evaluate the effectiveness of adding azithromycin to the standard treatment regimen for patients with COPD. Methods: In this clinical trial, 100 patients with COPD who were referred to the clinic and teaching hospitals of Shahrekord were divided into two groups. In addition to standard triple therapy (inhaled anticholinergic, inhaled bronchodilator, and inhaled corticosteroids), the experimental group received oral azithromycin at a dosage of 250 mg daily for two months. The control group received a placebo in conjunction with standard triple therapy. Both groups were assessed before and after the intervention using spirometry, blood oxygen saturation measurements, and the severity of dyspnea based on the Modified Medical Research Council (MMRC) criteria, as well as treatment outcomes. The data were analyzed using SPSS 22.0. Results: Following the intervention, the mean forced expiratory volume in one second (FEV1) increased by 4.28 (95% confidence interval [CI]: 3.93 to 4.63) in the intervention group compared to an increase of 3.78 (95% CI: 3.43 to 4.13) in the control group (P=0.004). The mean oxygen saturation improved by 4.88% (95% CI: 4.53 to 5.23) in the intervention group as opposed to an increase of 4.28% (95% CI: 3.93 to 4.63) in the control group (P=0.006). However, the MMRC score decreased by -0.82 (95% CI: -0.92 to -0.72) in the intervention group compared to a decrease of -0.54 (95% CI: -0.64 to -0.44) in the control group (P=0.002). Conclusion: The administration of azithromycin in conjunction with standard treatment demonstrated significantly improved outcomes compared to standard treatment alone.