{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:22:26Z","timestamp":1788495746422,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Flemish Government Agency for Innovation by Science and Technology","award":["IWT-TBM130233"],"award-info":[{"award-number":["IWT-TBM130233"]}]},{"name":"Toegepast Biomedisch onderzoek met eenprimair Maatschappelijke finaliteit\u201d","award":["IWT-TBM130233"],"award-info":[{"award-number":["IWT-TBM130233"]}]},{"name":"Belgian Thoracic Society"},{"name":"Belgian Thoracic Society"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Azithromycin prevents acute exacerbations of chronic obstructive pulmonary disease (AECOPDs); however, its value in the treatment of an AECOPD requiring hospitalization remains to be defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We investigated whether a 3-month intervention with low-dose azithromycin could decrease treatment failure (TF) when initiated at hospital admission and added to standard care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In an investigator-initiated, multicenter, randomized, double-blind, placebo-controlled trial, patients who had been hospitalized for an AECOPD and had a smoking history of \u226510 pack-years and one or more exacerbations in the previous year were randomized (1:1) within 48 hours of hospital admission to azithromycin or placebo. The study drug (500 mg\/d for 3 d) was administered on top of a standardized acute treatment of systemic corticosteroids and antibiotics, and subsequently continued for 3 months (250 mg\/2 d). The patients were followed for 6 months thereafter. Time-to-first-event analyses evaluated the TF rate within 3 months as a novel primary endpoint in the intention-to-treat population, with TF defined as the composite of treatment intensification with systemic corticosteroids and\/or antibiotics, a step-up in hospital care or readmission for respiratory reasons, or all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>A total of 301 patients were randomized to azithromycin (n\u2009=\u2009147) or placebo (n\u2009=\u2009154). The TF rate within 3 months was 49% in the azithromycin group and 60% in the placebo group (hazard ratio, 0.73; 95% confidence interval, 0.53\u20131.01; P\u2009=\u20090.0526). Treatment intensification, step-up in hospital care, and mortality rates within 3 months were 47% versus 60% (P\u2009=\u20090.0272), 13% versus 28% (P\u2009=\u20090.0024), and 2% versus 4% (P\u2009=\u20090.5075) in the azithromycin and placebo groups, respectively. Clinical benefits were lost 6 months after withdrawal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Three months of azithromycin for an infectious AECOPD requiring hospitalization may significantly reduce TF during the highest-risk period. Prolonged treatment seems to be necessary to maintain clinical benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201901-0094oc","type":"journal-article","created":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T03:02:16Z","timestamp":1556852536000},"page":"857-868","source":"Crossref","is-referenced-by-count":68,"title":["Azithromycin during Acute Chronic Obstructive Pulmonary Disease Exacerbations Requiring Hospitalization (BACE). A Multicenter, Randomized, Double-Blind, Placebo-controlled Trial"],"prefix":"10.1093","volume":"200","author":[{"given":"Kristina","family":"Vermeersch","sequence":"first","affiliation":[{"name":"Laboratory of Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing"},{"name":"Department of Respiratory Diseases and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gabrovska","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Centre Hospitalier Universitaire Saint-Pierre, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Aumann","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Jessa Ziekenhuis, Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingel K.","family":"Demedts","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, AZ Delta 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Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Haerens","sequence":"additional","affiliation":[{"name":"Department of Pneumology, AZ Groeninge, Kortrijk, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Hanon","sequence":"additional","affiliation":[{"name":"Department of Pneumology, UZ Brussel, Jette, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Jordens","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Onze-Lieve-Vrouw Ziekenhuis, Aalst, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudi","family":"Pech\u00e9","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Fremault","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Grand H\u00f4pital de Charleroi, Charleroi, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tine","family":"Lauwerier","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Imelda Ziekenhuis, Bonheiden, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Delporte","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bert","family":"Vandenberk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rik","family":"Willems","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Everaerts","sequence":"additional","affiliation":[{"name":"Laboratory of Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing"},{"name":"Department of Respiratory Diseases and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Belmans","sequence":"additional","affiliation":[{"name":"I-BioStat, and"},{"name":"Universiteit Hasselt, Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris","family":"Bogaerts","sequence":"additional","affiliation":[{"name":"I-BioStat, and"},{"name":"Universiteit Hasselt, Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert M.","family":"Verleden","sequence":"additional","affiliation":[{"name":"Laboratory of Respiratory Diseases, Department of Chronic Diseases, Metabolism and Ageing"},{"name":"Department of Respiratory Diseases 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