azithromycin for bronchiectasis patients with over 2 exacerbations per year

  • Avoid frequent exacerbations at all cost.
  • Azithromycin 500 mg 3x/week or 250 mg daily can reduce exacerbations and inflammations (BLESS, BAT, EMBRACE). 1
  • Check non-TB mycobacterium before starting chronic azithromycin to minimize risk of MAC resistance (use azithromycin with caution in patients with nonTB mycobacterium infections).
  • Most recent CHEST recommendation suggest starting azithromycin for ≥ 2 exacerbations2
  • monitor hearing and vestibular toxicity.3

Footnotes

  1. Bronchiectasis A Clinical Review ↩

  2. Management of Adult Bronchiectasis An American College of Chest Physicians Clinical Practice Guideline ↩

  3. Investigation and Management of Bronchiectasis in Nontuberculous Mycobacterial Pulmonary Disease ↩