{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:15:58Z","timestamp":1782166558088,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T00:00:00Z","timestamp":1549324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>Adult patients with chronic productive cough of unknown cause are commonly seen in respiratory clinics. We have previously described a subgroup of these patients who have a short\u2010lived response to standard antibiotic treatment but a prolonged response to 3 months of low\u2010dose azithromycin therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This observational study describes the physiological, radiological and pathological features of this patient cohort along with their response to a 12\u2010week open\u2010label trial of 250\u2009mg azithromycin thrice weekly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 30 subjects with a mean age of 57 were recruited. The majority demonstrated airway dilatation on high\u2010resolution computed tomography (HRCT) scan without evidence of established bronchiectasis (<jats:italic>n<\/jats:italic> =\u200921) and non\u2010specific chronic inflammatory changes on bronchial biopsy (<jats:italic>n<\/jats:italic> =\u200915\/17). Twenty\u2010nine subjects completed 3 months of azithromycin with a significant improvement in median Leicester Cough Questionnaire (LCQ) score (\u22126.3 points, <jats:italic>P<\/jats:italic> &lt; 0.00001), reduction in median 24\u2010h sputum volume (\u22125.8 mL, <jats:italic>P<\/jats:italic> = 0.0003) and improvement in sputum colour (<jats:italic>P<\/jats:italic> = 0.003). Patients responsive to azithromycin (<jats:italic>n<\/jats:italic> =\u200922) demonstrated neutrophilic or paucigranulocytic airway inflammation, whereas five subjects with eosinophilic airways inflammation did not respond symptomatically to azithromycin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We describe a cohort of patients with chronic productive cough not adequately described by existing disease labels whose symptoms responded well to low\u2010dose azithromycin. Many of the features are similar to the paediatric condition protracted bacterial bronchitis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13483","type":"journal-article","created":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T00:40:22Z","timestamp":1549413622000},"page":"558-565","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Idiopathic chronic productive cough and response to open\u2010label macrolide therapy: An observational study"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6942-5651","authenticated-orcid":false,"given":"Matthew J.","family":"Martin","sequence":"first","affiliation":[{"name":"The Asthma Centre, Nottingham NIHR Biomedical Research Centre University of Nottingham, Nottingham City Hospital  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Lee","sequence":"additional","affiliation":[{"name":"The Asthma Centre, Nottingham NIHR Biomedical Research Centre University of Nottingham, Nottingham City Hospital  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Clayton","sequence":"additional","affiliation":[{"name":"The Asthma Centre, Nottingham NIHR Biomedical Research Centre University of Nottingham, Nottingham City Hospital  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Pointon","sequence":"additional","affiliation":[{"name":"Department of Radiology Nottingham University Hospitals NHS Trust  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irshad","family":"Soomro","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology Nottingham University Hospitals NHS Trust  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominick E.","family":"Shaw","sequence":"additional","affiliation":[{"name":"The Asthma Centre, Nottingham NIHR Biomedical Research Centre University of Nottingham, Nottingham City Hospital  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim W.","family":"Harrison","sequence":"additional","affiliation":[{"name":"The Asthma Centre, Nottingham NIHR Biomedical Research Centre University of Nottingham, Nottingham City Hospital  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2015.05.020"},{"key":"e_1_2_8_3_1","first-page":"CD007716","article-title":"Macrolides for diffuse panbronchiolitis","volume":"2","author":"Yang M","year":"2013","journal-title":"Cochrane Database Syst. 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