Azithromycin Chronic Cough IPF
Credit: Getty Images

Research published in the Annals of the American Thoracic Society found that a low dose of azithromycin was ineffective in controlling chronic cough in patients with idiopathic pulmonary fibrosis (IPF). 

Patients with IPF frequently suffer from recurring chronic coughs, which affect their standard of living. Studies have shown that azithromycin alleviates the pain caused by chronic cough in specific populations.

A double-blind, randomized, controlled cross-over trial investigated the safety and efficacy of azithromycin in controlling chronic cough in patients with IPF. The study comprised 25 patients (23 men and 2 women) with IPF who went through two 3-month intervention periods, receiving azithromycin 500 mg or placebo 3 times per week.

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Get detailed prescribing information on the azithromycin monograph page on MPR.

The Leicester Cough Questionnaire (LCQ) measured the trial’s primary outcome, how cough impacted quality of life. Secondary outcomes were measured using the Visual Analog Scale (VAS), St. George’s Respiratory Questionnaire (SGRQ), and cough frequency measured using respiratory polygraphy.

Azithromycin for IPF
Structural chemical formula of the azithromycin molecule. Credit: Getty Images

There were no significant differences between the groups on the LCQ or VAS. The mean baseline LCQ scores were 11.7 and 11.3 for the azithromycin and the placebo arms, respectively, and the corresponding mean (SD) cough VAS scores were 5.6 (2.3) and 5.8 (2.1). Similarly, there was no major difference between the groups in polygraphy-measured cough frequency.

Abdominal adverse effects were more frequent with azithromycin than with placebo; 43% of the azithromycin group and 5% of the control group experienced diarrhea.

Out of the 25 patients who participated in the trial, 20 completed the study. Mean age was 67 years, mean forced vital capacity was 65%-predicted, and diffusion capacity was 43%-predicted.


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