Study objectives: To investigate whether erythromycin therapy lowers the fr
equency of the common cold and subsequent exacerbation in patients with COP
D.
Design: Prospective, randomized, controlled, but not blinded, trial.
Patients: One hundred nine patients with COPD were enrolled into the study.
Patients were randomly assigned to erythromycin therapy or to no active tr
eatment in September 1997. Patients then were observed for 12 months, start
ing in October, during which time the risk and frequency of catching common
colds and COPD exacerbations were investigated. Fifty-five patients receiv
ed erythromycin at study entry (erythromycin group). The remaining 54 patie
nts received no active treatment (control group).
Measurements and results: The mean (+/- SE) number of common colds for 12 m
onths was significantly lower in the erythromycin group than in the control
group (1.24 +/- 0.07 vs 4.54 +/- 0.02, respectively, per person; p = 0.000
2). Forty-one patients (76%) in the control group experienced common colds
more than once, compared to 7 patients (13%) in the erythromycin group. The
relative risk of developing two or more common colds in the control group
compared with that in the erythromycin group was 9.26 (95% confidence inter
val [CI], 3.92 to 31.74; p = 0.0001). Thirty patients (56%) in the control
group and 6 patients (11%) in the erythromycin group had one or more exacer
bations. The relative risk of experiencing an exacerbation in the control g
roup compared with that in the erythromycin group was 4.71 (95% CI, 1.53 to
14.5; p = 0.007). Significantly more patients were hospitalized due to exa
cerbations in the control group than in the erythromycin group (p = 0.0007)
.
Conclusion: Erythromycin therapy has beneficial effects on the prevention o
f exacerbations in COPD patients.