Patients with idiopathic pulmonary fibrosis (IPF) being treated with low dose azithromycin for cough did not see significant improvements compared with placebo, according to the results of a recent study published in the Annals of the American Thoracic Society.

Researchers conducted a double-blind, randomized placebo-controlled cross-over clinical trial ( Identifier: NCT02173145) treating patients with IPF with either azithromycin or placebo for 12 weeks, followed by the other treatment. Outcomes of interest included cough-related quality of life (measured by the Leicester Cough Questionnaire), cough severity (measured using Visual Analog Scale), health-related quality of life (assessed by the St. George’s Respiratory Questionnaire), and objective cough frequency.

Among the 25 participants recruited, 23 were men and the mean age was 67 years. Additionally, mean forced vital capacity was 65 percent predicted, and diffusion capacity 43 percent predicted at baseline. Following the treatment phases, there was no significant change in Leicester Cough Questionnaire and Visual Analog Scale scores with azithromycin or placebo. Similarly, there was no significant difference in change in respiratory polygraphy measured cough frequency. When adverse effects were considered, gastrointestinal adverse effects such as diarrhea were more frequent with azithromycin than with placebo (43% vs 5%; P =.03).

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“This randomized controlled trial does not support the use of low dose azithromycin for chronic cough in patients with [idiopathic pulmonary fibrosis],” the study authors concluded.


Guler SA, Clarenbach C, Brutsche M, et al. Azithromycin for the treatment of chronic cough in idiopathic pulmonary fibrosis: a randomized controlled cross-over trial. Ann Am Thorac Soc. Published online May 20, 2021. doi:10.1513/AnnalsATS.202103-266OC