Low-dose Azithromycin improves phagocytosis of bacteria by both alveolar and monocyte-derived macrophagesin COPD subjects

Respirology, 04/19/2012

Hodge S et al. - The data provide further support for the long term use of low dose azithromycin as an attractive adjunct treatment option for COPD. Improved clearance of both apoptotic cells and bacteria in the airway may have a dual effect; reducing the risk of secondary necrosis and release of toxic cell contents that perpetuate inflammation as well as contributing to a reduction in the rate of exacerbations in COPD.


  • The authors firstly investigated whether there were defects in the ability of both alveolar (AM) or monocyte-derived macrophages (MDM) to phagocytose bacteria in COPD, as the authors have previously reported for phagocytosis of apoptotic cells.
  • The authors then assessed the effects of administration of low-dose azithromycin to COPD patients on the ability of AM and MDM to phagocytose bacteria.
  • Azithromycin (250mg orally daily for five days then 2x weekly (total 12 weeks)) was administered to 11 COPD subjects and phagocytosis of FITC-labelled E. coli assessed by flow cytometry.


  • COPD subjects had a significant defect in the ability of both AM and MDM to phagocytose bacteria that was significantly improved by administration of low-dose azithromycin.

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