Study objectives: To investigate whether erythromycin
therapy lowers the frequency of the common cold and subsequent
exacerbation in patients with COPD.
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 treatment in September 1997. Patients then were
observed for 12 months, starting in October, during which time the risk
and frequency of catching common colds and COPD exacerbations were
investigated. Fifty-five patients received erythromycin at study entry
(erythromycin group). The remaining 54 patients received no active
treatment (control group).
Measurements and results:
The mean (± SE) number of common colds for 12 months 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 = 0.0002). 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 interval [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
exacerbations. The relative risk of experiencing an exacerbation in the
control group 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 exacerbations in the control group than in the
erythromycin group (p = 0.0007).
Erythromycin therapy has beneficial effects on the prevention of
exacerbations in COPD patients.