Chronic Azithromycin Use in Cystic Fibrosis and Risk of Treatment-Emergent Respiratory Pathogens

Annals of the American Thoracic Society
Jonathan D CogenMargaret Rosenfeld

Abstract

Azithromycin has been shown to improve lung function and reduce the number of pulmonary exacerbations in patients with cystic fibrosis. Concerns remain, however, regarding the potential emergence of treatment-related respiratory pathogens. To determine whether chronic azithromycin use (defined as three-times weekly administration) is associated with increased rates of detection of eight specific respiratory pathogens. We performed a new-user, propensity score-matched retrospective cohort study utilizing data from the Cystic Fibrosis Foundation Patient Registry. Incident azithromycin users were propensity score matched 1:1 with contemporaneous nonusers. Kaplan-Meier curves and Cox proportional hazards regression were used to evaluate the association between chronic azithromycin use and incident respiratory pathogen detection. Analyses were performed separately for each pathogen, limited to patients among whom that pathogen had not been isolated in the 2 years before cohort entry. After propensity score matching, the mean age of the cohorts was approximately 12 years. Chronic azithromycin users had a significantly lower risk of detection of new methicillin-resistant Staphylococcus aureus, nontuberculous mycobacteria, and Burkhold...Continue Reading

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Citations

Jun 2, 2018·Annals of the American Thoracic Society·Valerie Waters
Sep 11, 2019·Current Opinion in Pulmonary Medicine·Renske van der MeerHarry G M Heijerman
Mar 28, 2019·American Journal of Respiratory and Critical Care Medicine·Bonnie W RamseyChristopher H Goss
Nov 18, 2020·Der Internist·F C RingshausenA-M Dittrich
Apr 1, 2021·BMC Microbiology·Nicole AcostaMichael D Parkins
May 11, 2021·Frontiers in Microbiology·Manoj KumarNobuhisa Masuda

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