AZMATICS: AZithroMycin/Asthma: Trial in Community Settings

This project was conducted from April 2006 through August 2008 and funded by the American Academy of Family Physicians Foundation, Wisconsin Academy of Family Physicians, Pfizer (for in-kind supply of study drug). This study was run out of the office of David Hahn, MD, MS, Clinical Professor, Department of Family Medicine, University of Wisconsin Medical School and the Wisconsin Research Network (WREN). The AAFP NRN was one of several PBRNs participating in this study with Dr. Hahn, the Principal Investigator for the study. This was a pilot randomized “practical clinical” that tested the hypothesis that azithromycin, an anti-chlamydial antibiotic treatment, would significantly improve asthma control (decrease symptoms and medication use) by 12 weeks (end treatment) and the improvement continues to 12 months (end study). In the 12-month study, we examined the overall asthma symptoms, asthma medication use, quality of life, and exacerbations of approximately 600 older children and adults.The primary outcome variable was overall asthma symptoms. Secondary outcomes are asthma medication use, quality of life and exacerbations.  

Specific Aims and Objectives

1. Assess the impact of 12-week treatment with azithromycin on pre-specified patient-oriented asthma outcomes:
   1. Asthma symptoms
   2. Asthma rescue medication use
   3. Asthma quality of life (QOL)
   4. Asthma exacerbations
2. Assess the impact of 12-week treatment with azithromycin on pre-specified asthma subgroups:
   1. Smoking
   2. Co-morbid respiratory conditions (diagnoses of “chronic asthmatic bronchitis” and “asthma with chronic airways obstruction”)

Key Findings and Publications

Adults with asthma who were randomized to azithromycin did not show statistically significant improvement in asthma outcomes, although the study was underpowered to detect clinical improvement in 15%. Adults with severe persistent asthma who elected OL treatment documented clinical improvements in asthma symptoms, AQL, and asthma control that persisted after completion of OL azithromycin.

Azithromycin for Bronchial Asthma in Adults: An Effectiveness Trial. Hahn DL, Grasmick M, Hetzel S, et al, and on behalf of the AZMATICS Study Group.  J Am Board Fam Med. 2012;25(4):442-459.