Imperial College London
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ProfessorDeborahAshby

Faculty of Medicine, School of Public Health

Dean of the Faculty of Medicine
 
 
 
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Contact

 

+44 (0)20 7594 8704deborah.ashby Website

 
 
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Location

 

2.15Faculty BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Johnston:2016:10.1001/jamainternmed.2016.5664,
author = {Johnston, SL and Szigeti, M and Cross, M and Brightling, C and Chaudhuri, R and Harrison, T and Mansur, A and Robison, L and Sattar, Z and Jackson, D and Mallia, P and Wong, E and Corrigan, C and Higgins, B and Ind, P and Singh, D and Thomson, NC and Ashby, D and Chauhan, A},
doi = {10.1001/jamainternmed.2016.5664},
journal = {JAMA Internal Medicine},
pages = {1630--1637},
title = {Azithromycin for acute exacerbations of asthma. The AZALEA randomized clinical trial},
url = {http://dx.doi.org/10.1001/jamainternmed.2016.5664},
volume = {176},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Importance  Guidelines recommend against antibiotic use to treat asthma attacks. A study with telithromycin reported benefit, but adverse reactions limit its use.Objective  To determine whether azithromycin added to standard care for asthma attacks in adults results in clinical benefit.Design, Setting, and Participants  The Azithromycin Against Placebo in Exacerbations of Asthma (AZALEA) randomized, double-blind, placebo-controlled clinical trial, a United Kingdom–based multicenter study in adults requesting emergency care for acute asthma exacerbations, ran from September 2011 to April 2014. Adults with a history of asthma for more than 6 months were recruited within 48 hours of presentation to medical care with an acute deterioration in asthma control requiring a course of oral and/or systemic corticosteroids.Interventions  Azithromycin 500 mg daily or matched placebo for 3 days.Main Outcomes and Measures  The primary outcome was diary card symptom score 10 days after randomization, with a hypothesized treatment effect size of −0.3. Secondary outcomes were diary card symptom score, quality-of-life questionnaires, and lung function changes, all between exacerbation and day 10, and time to a 50% reduction in symptom score.Results  Of 4582 patients screened at 31 centers, 199 of a planned 380 were randomized within 48 hours of presentation. The major reason for nonrecruitment was receipt of antibiotics (2044 [44.6%] screened patients). Median time from presentation to drug administration was 22 hours (interquartile range, 14-28 hours). Exacerbation characteristics were well balanced across treatment arms and centers. The primary outcome asthma symptom scores were mean (SD), 4.14 (1.38) at exacerbation and 2.09 (1.71) at 10 days for the azithromycin group and 4.18 (1.48) and 2.20 (1.51) for the placebo group, respectively. Using multilevel modeling, there was no significant difference in symptom scores between azithromycin and placebo at day 10 (difference
AU  - Johnston,SL
AU  - Szigeti,M
AU  - Cross,M
AU  - Brightling,C
AU  - Chaudhuri,R
AU  - Harrison,T
AU  - Mansur,A
AU  - Robison,L
AU  - Sattar,Z
AU  - Jackson,D
AU  - Mallia,P
AU  - Wong,E
AU  - Corrigan,C
AU  - Higgins,B
AU  - Ind,P
AU  - Singh,D
AU  - Thomson,NC
AU  - Ashby,D
AU  - Chauhan,A
DO  - 10.1001/jamainternmed.2016.5664
EP  - 1637
PY  - 2016///
SN  - 2168-6106
SP  - 1630
TI  - Azithromycin for acute exacerbations of asthma. The AZALEA randomized clinical trial
T2  - JAMA Internal Medicine
UR  - http://dx.doi.org/10.1001/jamainternmed.2016.5664
UR  - http://hdl.handle.net/10044/1/40850
VL  - 176
ER  -
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