{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:32:27Z","timestamp":1792798347687,"version":"4.5.0"},"reference-count":158,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Macrolides\u2014especially azithromycin\u2014have been increasingly investigated in chronic respiratory diseases for their combined antimicrobial, anti-inflammatory, and immunomodulatory properties. Randomized controlled trials have demonstrated significant reductions in exacerbation frequency in selected patient populations with bronchiectasis, COPD, and asthma, although benefits on lung function and quality of life are variable. Beyond these advantages, concerns remain regarding antimicrobial resistance and uncertainties about long-term safety. Different guidelines across various diseases therefore recommend cautious and selective use of macrolides, with attention to phenotype selection, while alternative or emerging options such as biologics and novel anti-inflammatory agents are reshaping the therapeutic landscape. In this narrative review, we analyze the evidence for macrolide therapy across major chronic respiratory diseases, highlighting both the enduring clinical relevance and the limitations of long-term macrolide therapy, and discussing whether these drugs are approaching their therapeutic dusk or could still open a new dawn for selected patients. To this end we researched EMBASE and PubMed for articles published in English between 2000 and 2020 with restrictions to original articles, and freely between 2021 and 2025.<\/jats:p>","DOI":"10.3390\/antibiotics14111061","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:47:36Z","timestamp":1761266856000},"page":"1061","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Long-Term Macrolides in Chronic Respiratory Diseases: Dusk or a New Dawn? A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Daniele","family":"Previtero","sequence":"first","affiliation":[{"name":"Respiratory Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5925-4035","authenticated-orcid":false,"given":"Gioele","family":"Castelli","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ylenia","family":"Padrin","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Santello","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1374-1505","authenticated-orcid":false,"given":"Daniele","family":"Mengato","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Unit, Azienda Ospedale-Universit\u00e0 Padova, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0726-0812","authenticated-orcid":false,"given":"Davide","family":"Biondini","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1895-6388","authenticated-orcid":false,"given":"Graziella","family":"Turato","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariaenrica","family":"Tin\u00e9","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1096-0596","authenticated-orcid":false,"given":"Paolo","family":"Spagnolo","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6739-8629","authenticated-orcid":false,"given":"Umberto","family":"Semenzato","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padua, PD, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2967","DOI":"10.1111\/bph.13936","article-title":"The Macrolide Antibiotic Renaissance","volume":"174","author":"Dinos","year":"2017","journal-title":"Br. J. Pharmacol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.1016\/S0960-894X(99)00534-X","article-title":"Synthesis and Antibacterial Activity of HMR 3647 a New Ketolide Highly Potent against Erythromycin-Resistant and Susceptible Pathogens","volume":"9","author":"Denis","year":"1999","journal-title":"Bioorg. Med. Chem. Lett."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/S2213-2600(20)30080-1","article-title":"Immunomodulation by Macrolides: Therapeutic Potential for Critical Care","volume":"8","author":"Reijnders","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/j.1365-2249.2011.04480.x","article-title":"The Effect of Azithromycin on the Maturation and Function of Murine Bone Marrow-Derived Dendritic Cells","volume":"166","author":"Iwamoto","year":"2011","journal-title":"Clin. Exp. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1111\/j.1440-1843.2012.02135.x","article-title":"Low-dose Azithromycin Improves Phagocytosis of Bacteria by Both Alveolar and Monocyte-derived Macrophagesin Chronic Obstructive Pulmonary Disease Subjects","volume":"17","author":"Hodge","year":"2012","journal-title":"Respirology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"00031","DOI":"10.1183\/23120541.00031-2018","article-title":"Azithromycin Treatment Modifies Airway and Blood Gene Expression Networks in Neutrophilic COPD","volume":"4","author":"Baines","year":"2018","journal-title":"ERJ Open Res."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Huang, D., Xie, L., Luo, T., Lin, L., Ren, Q., Zeng, Z., Huang, H., Liao, H., Chang, X., and Chen, Y. (2025). Effects of Azithromycin on Alleviating Airway Inflammation in Asthmatic Mice by Regulating Airway Microbiota and Metabolites. Microbiol. Spectr., 13.","DOI":"10.1128\/spectrum.02217-24"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1159\/000538911","article-title":"Long-Term Erythromycin Treatment Alters the Airway and Gut Microbiota: Data from Chronic Obstructive Pulmonary Disease Patients and Mice with Emphysema","volume":"103","author":"Pei","year":"2024","journal-title":"Respiration"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"00720","DOI":"10.1183\/23120541.00720-2022","article-title":"Azithromycin Alters Spatial and Temporal Dynamics of Airway Microbiota in Idiopathic Pulmonary Fibrosis","volume":"9","author":"Gijs","year":"2023","journal-title":"ERJ Open Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"17981","DOI":"10.1073\/pnas.1316981110","article-title":"A Quorum-Sensing Inhibitor Blocks Pseudomonas aeruginosa Virulence and Biofilm Formation","volume":"110","author":"Miller","year":"2013","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4243","DOI":"10.1128\/AAC.00613-07","article-title":"Ribosome Protection Prevents Azithromycin-Mediated Quorum-Sensing Modulation and Stationary-Phase Killing of Pseudomonas aeruginosa","volume":"51","author":"Dumas","year":"2007","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Suzuki, S., Morita, Y., Ishige, S., Kai, K., Kawasaki, K., Matsushita, K., Ogura, K., Miyoshi-Akiyama, T., and Shimizu, T. (2024). Effects of Quorum Sensing\u2013Interfering Agents, Including Macrolides and Furanone C-30, and an Efflux Pump Inhibitor on Nitrosative Stress Sensitivity in Pseudomonas aeruginosa. Microbiology, 170.","DOI":"10.1099\/mic.0.001464"},{"key":"ref_13","first-page":"1697","article-title":"Macrolide Treatment Inhibits Pseudomonas aeruginosa Quorum Sensing in Non-CF Bronchiectasis: An Analysis from the BLESS Trial","volume":"13","author":"Burr","year":"2016","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/S0140-6736(12)60953-2","article-title":"Azithromycin for Prevention of Exacerbations in Non-Cystic Fibrosis Bronchiectasis (EMBRACE): A Randomised, Double-Blind, Placebo-Controlled Trial","volume":"380","author":"Wong","year":"2012","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1001\/jama.2013.1937","article-title":"Effect of Azithromycin Maintenance Treatment on Infectious Exacerbations Among Patients with Non\u2013Cystic Fibrosis Bronchiectasis: The BAT Randomized Controlled Trial","volume":"309","author":"Altenburg","year":"2013","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1111\/resp.12130","article-title":"Effects of Long-term Azithromycin Therapy on Airway Oxidative Stress Markers in Non-cystic Fibrosis Bronchiectasis","volume":"18","author":"Diego","year":"2013","journal-title":"Respirology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"117","DOI":"10.2165\/00151829-200504020-00005","article-title":"The Disease-Modifying Effects of Twice-Weekly Oral Azithromycin in Patients with Bronchiectasis","volume":"4","author":"Cymbala","year":"2005","journal-title":"Treat. Respir. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/S2213-2600(25)00160-2","article-title":"Symptoms, Risk of Future Exacerbations, and Response to Long-Term Macrolide Treatment in Bronchiectasis: An Observational Study","volume":"13","author":"Sibila","year":"2025","journal-title":"Lancet Respir. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1128\/AAC.02466-12","article-title":"Macrolides Inhibit Fusobacterium nucleatum-Induced MUC5AC Production in Human Airway Epithelial Cells","volume":"57","author":"Nagaoka","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1001\/jama.2013.2290","article-title":"Effect of Long-Term, Low-Dose Erythromycin on Pulmonary Exacerbations Among Patients with Non\u2013Cystic Fibrosis Bronchiectasis: The BLESS Randomized Controlled Trial","volume":"309","author":"Serisier","year":"2013","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"708608","DOI":"10.1155\/2014\/708608","article-title":"Effect of Low-Dose, Long-Term Roxithromycin on Airway Inflammation and Remodeling of Stable Noncystic Fibrosis Bronchiectasis","volume":"2014","author":"Liu","year":"2014","journal-title":"Mediators Inflamm."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Hashimoto, K., Abe, Y., Fukushima, K., Niitsu, T., Komukai, S., Miyamoto, S., Nii, T., Matsuki, T., Takeuchi, N., and Morimoto, K. (2024). Epidemiology of Bronchiectasis at a Single Center in Japan: A Retrospective Cohort Study. BMC Pulm. Med., 24.","DOI":"10.1186\/s12890-024-03337-7"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/S2213-2600(19)30191-2","article-title":"Long-Term Macrolide Antibiotics for the Treatment of Bronchiectasis in Adults: An Individual Participant Data Meta-Analysis","volume":"7","author":"Chalmers","year":"2019","journal-title":"Lancet Respir. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/S2213-2600(14)70213-9","article-title":"The Effect of Long-Term Macrolide Treatment on Respiratory Microbiota Composition in Non-Cystic Fibrosis Bronchiectasis: An Analysis from the Randomised, Double-Blind, Placebo-Controlled BLESS Trial","volume":"2","author":"Rogers","year":"2014","journal-title":"Lancet Respir. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"106718","DOI":"10.1016\/j.rmed.2021.106718","article-title":"The Effect of Maintenance Azithromycin on Radiological Features in Patients with Bronchiectasis\u2014Analysis from the BAT Randomized Controlled Trial","volume":"192","author":"Terpstra","year":"2022","journal-title":"Respir. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2401574","DOI":"10.1183\/13993003.01574-2024","article-title":"Cardiovascular Benefits and Safety Profile of Macrolide Maintenance Therapy in Patients with Bronchiectasis","volume":"65","author":"Guo","year":"2025","journal-title":"Eur. Respir. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1700629","DOI":"10.1183\/13993003.00629-2017","article-title":"European Respiratory Society Guidelines for the Management of Adult Bronchiectasis","volume":"50","author":"Polverino","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_28","first-page":"1","article-title":"British Thoracic Society Guideline for Bronchiectasis in Adults","volume":"74","author":"Hill","year":"2019","journal-title":"Thorax"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.chest.2024.01.045","article-title":"The Efficacy and Safety of Inhaled Antibiotics for the Treatment of Bronchiectasis in Adults","volume":"166","author":"Cordeiro","year":"2024","journal-title":"Chest"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/S2213-2600(24)00176-0","article-title":"Rethinking Bronchiectasis as an Inflammatory Disease","volume":"12","author":"Long","year":"2024","journal-title":"Lancet Respir. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.chest.2023.07.013","article-title":"Inhaled Corticosteroids in COPD and Bronchiectasis","volume":"164","author":"Chalmers","year":"2023","journal-title":"Chest"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1056\/NEJMoa2411664","article-title":"Phase 3 Trial of the DPP-1 Inhibitor Brensocatib in Bronchiectasis","volume":"392","author":"Chalmers","year":"2025","journal-title":"N. Engl. J. Med."},{"key":"ref_33","first-page":"S3","article-title":"International Consensus Statement on Allergy and Rhinology: Rhinosinusitis Executive Summary","volume":"6","author":"Orlandi","year":"2016","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_34","unstructured":"Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2025, August 21). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2025 Report., Available online: https:\/\/goldcopd.org\/2025-gold-report\/."},{"key":"ref_35","unstructured":"Global Initiative for Asthma (2025, August 21). Global Strategy for Asthma Management and Prevention, 2025 Report. Updated May 2025, Available online: https:\/\/ginasthma.org\/2025-gina-strategy-report\/."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"00633","DOI":"10.1183\/23120541.00633-2022","article-title":"A Phase 2 Randomised Study to Establish Efficacy, Safety and Dosing of a Novel Oral Cathepsin C Inhibitor, BI 1291583, in Adults with Bronchiectasis: Airleaf","volume":"9","author":"Chalmers","year":"2023","journal-title":"ERJ Open Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1136\/thoraxjnl-2012-202698","article-title":"Azithromycin for Prevention of Exacerbations in Severe Asthma (AZISAST): A Multicentre Randomised Double-Blind Placebo-Controlled Trial","volume":"68","author":"Brusselle","year":"2013","journal-title":"Thorax"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.jaci.2010.07.024","article-title":"A Trial of Clarithromycin for the Treatment of Suboptimally Controlled Asthma","volume":"126","author":"Sutherland","year":"2010","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"442","DOI":"10.3122\/jabfm.2012.04.110309","article-title":"Azithromycin for Bronchial Asthma in Adults: An Effectiveness Trial","volume":"25","author":"Hahn","year":"2012","journal-title":"J. Am. Board Fam. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S0140-6736(17)31281-3","article-title":"Effect of Azithromycin on Asthma Exacerbations and Quality of Life in Adults with Persistent Uncontrolled Asthma (AMAZES): A Randomised, Double-Blind, Placebo-Controlled Trial","volume":"390","author":"Gibson","year":"2017","journal-title":"Lancet"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"106494","DOI":"10.1016\/j.rmed.2021.106494","article-title":"Effect of Azithromycin on Bronchial Wall Thickness in Severe Persistent Asthma: A Double-Blind Placebo-Controlled Randomized Clinical Trial","volume":"185","author":"Sadeghdoust","year":"2021","journal-title":"Respir. Med."},{"key":"ref_42","first-page":"CD002997","article-title":"Macrolides versus Placebo for Chronic Asthma","volume":"2021","author":"Undela","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.5694\/mja18.00207","article-title":"Health-related Quality of Life Burden in Severe Asthma","volume":"209","author":"McDonald","year":"2018","journal-title":"Med. J. Aust."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1164\/rccm.200707-1134OC","article-title":"Clarithromycin Targets Neutrophilic Airway Inflammation in Refractory Asthma","volume":"177","author":"Simpson","year":"2008","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/S1081-1206(10)62409-X","article-title":"Clarithromycin Suppresses Bronchial Hyperresponsiveness Associated with Eosinophilic Inflammation in Patients with Asthma","volume":"84","author":"Amayasu","year":"2000","journal-title":"Ann. Allergy. Asthma. Immunol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1164\/ajrccm.164.4.2011040","article-title":"Trial of Roxithromycin in Subjects with Asthma and Serological Evidence of Infection with Chlamydia pneumoniae","volume":"164","author":"Black","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1378\/chest.121.6.1782","article-title":"Mycoplasma pneumoniae and Chlamydia pneumoniae in Asthma","volume":"121","author":"Kraft","year":"2002","journal-title":"Chest"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1183\/09031936.04.00118404","article-title":"Clarithromycin Reduces the Severity of Bronchial Hyperresponsiveness in Patients with Asthma","volume":"23","author":"Kostadima","year":"2004","journal-title":"Eur. Respir. J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1081\/JAS-120002199","article-title":"Effect of Azithromycin on the Severity of Bronchial Hyperresponsiveness in Patients with Mild Asthma","volume":"39","author":"Ekici","year":"2002","journal-title":"J. Asthma"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1111\/all.14768","article-title":"Sputum TNF Markers Are Increased in Neutrophilic and Severe Asthma and Are Reduced by Azithromycin Treatment","volume":"76","author":"Niessen","year":"2021","journal-title":"Allergy"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1067\/mai.2001.113563","article-title":"A Link between Chronic Asthma and Chronic Infection","volume":"107","author":"Martin","year":"2001","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1183\/09031936.94.07071239","article-title":"Reversible Airflow Limitation in Adults with Respiratory Infection","volume":"7","author":"Melbye","year":"1994","journal-title":"Eur. Respir. J."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Hahn, D.L., Plane, M.B., Mahdi, O.S., and Byrne, G.I. (2006). Secondary Outcomes of a Pilot Randomized Trial of Azithromycin Treatment for Asthma. PLoS Clin. Trials, 1.","DOI":"10.1371\/journal.pctr.0010011"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/1465-9921-11-90","article-title":"Azithromycin Attenuates Airway Inflammation in a Mouse Model of Viral Bronchiolitis","volume":"11","author":"Beigelman","year":"2010","journal-title":"Respir. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1164\/rccm.201809-1739OC","article-title":"Long-Term Azithromycin Reduces Haemophilus influenzae and Increases Antibiotic Resistance in Severe Asthma","volume":"200","author":"Taylor","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_56","unstructured":"(2025, August 21). British Thoracic Society, Scottish Intercollegiate Guidelines Network. Available online: https:\/\/www.nice.org.uk\/Guidance\/NG245."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1900588","DOI":"10.1183\/13993003.00588-2019","article-title":"Management of Severe Asthma: A European Respiratory Society\/American Thoracic Society Guideline","volume":"55","author":"Holguin","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1111\/all.14221","article-title":"Efficacy and Safety of Treatment with Biologicals (Benralizumab, Dupilumab, Mepolizumab, Omalizumab and Reslizumab) for Severe Eosinophilic Asthma. A Systematic Review for the EAACI Guidelines\u2014Recommendations on the Use of Biologicals in Severe Asthma","volume":"75","author":"Agache","year":"2020","journal-title":"Allergy"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1056\/NEJMoa2034975","article-title":"Tezepelumab in Adults and Adolescents with Severe, Uncontrolled Asthma","volume":"384","author":"Corren","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1164\/rccm.202210-2005OC","article-title":"Efficacy of Tezepelumab in Severe, Uncontrolled Asthma: Pooled Analysis of the PATHWAY and NAVIGATOR Clinical Trials","volume":"208","author":"Corren","year":"2023","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1136\/thorax-2024-221977","article-title":"Effects of Azithromycin in Severe Eosinophilic Asthma with Concomitant Monoclonal Antibody Treatment","volume":"80","author":"Lavoie","year":"2025","journal-title":"Thorax"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.chest.2024.02.048","article-title":"Effect of Azithromycin on Asthma Remission in Adults with Persistent Uncontrolled Asthma","volume":"166","author":"Thomas","year":"2024","journal-title":"Chest"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.chest.2023.10.046","article-title":"Clinical Response and Remission in Patients with Severe Asthma Treated with Biologic Therapies","volume":"165","author":"Hansen","year":"2024","journal-title":"Chest"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1186\/s12931-020-01526-6","article-title":"NAVIGATOR: A Phase 3 Multicentre, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Trial to Evaluate the Efficacy and Safety of Tezepelumab in Adults and Adolescents with Severe, Uncontrolled Asthma","volume":"21","author":"Colice","year":"2020","journal-title":"Respir. Res."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1164\/rccm.200801-145OC","article-title":"Long-Term Erythromycin Therapy Is Associated with Decreased Chronic Obstructive Pulmonary Disease Exacerbations","volume":"178","author":"Seemungal","year":"2008","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1378\/chest.120.3.730","article-title":"Erythromycin and Common Cold in COPD","volume":"120","author":"Suzuki","year":"2001","journal-title":"Chest"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1183\/09031936.05.00043405","article-title":"Epidemiological Relationships between the Common Cold and Exacerbation Frequency in COPD","volume":"26","author":"Hurst","year":"2005","journal-title":"Eur. Respir. J."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.rmed.2004.06.009","article-title":"The Effect of Oral Clarithromycin on Health Status and Sputum Bacteriology in Stable COPD","volume":"99","author":"Banerjee","year":"2005","journal-title":"Respir. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1056\/NEJMoa1104623","article-title":"Azithromycin for Prevention of Exacerbations of COPD","volume":"365","author":"Albert","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1164\/rccm.201402-0207OC","article-title":"Predictors of Chronic Obstructive Pulmonary Disease Exacerbation Reduction in Response to Daily Azithromycin Therapy","volume":"189","author":"Han","year":"2014","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S2213-2600(14)70019-0","article-title":"Azithromycin Maintenance Treatment in Patients with Frequent Exacerbations of Chronic Obstructive Pulmonary Disease (COLUMBUS): A Randomised, Double-Blind, Placebo-Controlled Trial","volume":"2","author":"Uzun","year":"2014","journal-title":"Lancet Respir. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"495","DOI":"10.2147\/COPD.S284397","article-title":"Long-Term Azithromycin Maintenance Treatment in Patients with Frequent Exacerbations of Chronic Obstructive Pulmonary Disease","volume":"16","author":"Talman","year":"2021","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1164\/rccm.201901-0094OC","article-title":"Azithromycin during Acute Chronic Obstructive Pulmonary Disease Exacerbations Requiring Hospitalization (BACE). A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial","volume":"200","author":"Vermeersch","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1186\/s12931-019-1208-6","article-title":"Treatment Failure and Hospital Readmissions in Severe COPD Exacerbations Treated with Azithromycin versus Placebo\u2014A Post-Hoc Analysis of the BACE Randomized Controlled Trial","volume":"20","author":"Vermeersch","year":"2019","journal-title":"Respir. Res."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Cuevas, E., Huertas, D., Mont\u00f3n, C., Marin, A., Carrera-Salinas, A., Pomares, X., Garc\u00eda-Nu\u00f1ez, M., Mart\u00ed, S., and Santos, S. (2023). Systemic and Functional Effects of Continuous Azithromycin Treatment in Patients with Severe Chronic Obstructive Pulmonary Disease and Frequent Exacerbations. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1229463"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.chest.2018.01.044","article-title":"Clinical and Safety Outcomes of Long-Term Azithromycin Therapy in Severe COPD Beyond the First Year of Treatment","volume":"153","author":"Pomares","year":"2018","journal-title":"Chest"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.rmed.2019.06.005","article-title":"Blood Eosinophil Count and GOLD Stage Predict Response to Maintenance Azithromycin Treatment in COPD Patients with Frequent Exacerbations","volume":"154","author":"Djamin","year":"2019","journal-title":"Respir. Med."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.pupt.2009.12.002","article-title":"Long-Term Azithromycin Use in Patients with Chronic Obstructive Pulmonary Disease and Tracheostomy","volume":"23","author":"Blasi","year":"2010","journal-title":"Pulm. Pharmacol. Ther."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"4173962","DOI":"10.1155\/2016\/4173962","article-title":"Effects of Low-Dose and Long-Term Treatment with Erythromycin on Interleukin-17 and Interleukin-23 in Peripheral Blood and Induced Sputum in Patients with Stable Chronic Obstructive Pulmonary Disease","volume":"2016","author":"Tan","year":"2016","journal-title":"Mediators Inflamm."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/1465-9921-14-125","article-title":"Azithromycin and Cough-Specific Health Status in Patients with Chronic Obstructive Pulmonary Disease and Chronic Cough: A Randomised Controlled Trial","volume":"14","author":"Berkhof","year":"2013","journal-title":"Respir. Res."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/s13756-020-00783-w","article-title":"Prevalence and Abundance of Selected Genes Conferring Macrolide Resistance Genes in COPD Patients During Maintenance Treatment with Azithromycin","volume":"9","author":"Djamin","year":"2020","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Carrera-Salinas, A., Gonz\u00e1lez-D\u00edaz, A., Ehrlich, R.L., Berbel, D., Tubau, F., Pomares, X., Garmendia, J., Dom\u00ednguez, M.\u00c1., Ardanuy, C., and Huertas, D. (2023). Genetic Adaptation and Acquisition of Macrolide Resistance in Haemophilus Spp. During Persistent Respiratory Tract Colonization in Chronic Obstructive Pulmonary Disease (COPD) Patients Receiving Long-Term Azithromycin Treatment. Microbiol. Spectr., 11.","DOI":"10.1128\/spectrum.03860-22"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1465-9921-12-18","article-title":"Reduction of Exacerbations by the PDE4 Inhibitor Roflumilast\u2014The Importance of Defining Different Subsets of Patients with COPD","volume":"12","author":"Rennard","year":"2011","journal-title":"Respir. Res."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/S0140-6736(14)62410-7","article-title":"Effect of Roflumilast on Exacerbations in Patients with Severe Chronic Obstructive Pulmonary Disease Uncontrolled by Combination Therapy (REACT): A Multicentre Randomised Controlled Trial","volume":"385","author":"Martinez","year":"2015","journal-title":"The Lancet"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"3449","DOI":"10.2147\/COPD.S143967","article-title":"Risk Factors for the Discontinuation of Roflumilast in Patients with Chronic Obstructive Pulmonary Disease","volume":"12","author":"Kim","year":"2017","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"ref_86","first-page":"450","article-title":"Comparative Effectiveness of Roflumilast and Azithromycin for the Treatment of Chronic Obstructive Pulmonary Disease","volume":"8","author":"Lam","year":"2021","journal-title":"Chronic Obstr. Pulm. Dis. J. COPD Found."},{"key":"ref_87","unstructured":"NCT04069312 (2025, August 21). Roflumilast or Azithromycin to Prevent COPD Exacerbations (RELIANCE) Study, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04069312."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1164\/rccm.201708-1684LE","article-title":"Blood Eosinophilia Neither Reflects Tissue Eosinophils nor Worsens Clinical Outcomes in Chronic Obstructive Pulmonary Disease","volume":"197","author":"Turato","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Tin\u00e8, M., Biondini, D., Semenzato, U., Bazzan, E., Cosio, M.G., Saetta, M., and Turato, G. (2019). Reassessing the Role of Eosinophils as a Biomarker in Chronic Obstructive Pulmonary Disease. J. Clin. Med., 8.","DOI":"10.3390\/jcm8070962"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/resp.12475","article-title":"Relationship between Blood and Bronchial Submucosal Eosinophilia and Reticular Basement Membrane Thickening in Chronic Obstructive Pulmonary Disease","volume":"20","author":"Eltboli","year":"2015","journal-title":"Respirology"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1056\/NEJMoa1708208","article-title":"Mepolizumab for Eosinophilic Chronic Obstructive Pulmonary Disease","volume":"377","author":"Pavord","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.2147\/COPD.S294333","article-title":"Mepolizumab for Eosinophil-Associated COPD: Analysis of METREX and METREO","volume":"16","author":"Pavord","year":"2021","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1056\/NEJMoa2413181","article-title":"Mepolizumab to Prevent Exacerbations of COPD with an Eosinophilic Phenotype","volume":"392","author":"Sciurba","year":"2025","journal-title":"N. Engl. J. Med."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1056\/NEJMoa2401304","article-title":"Dupilumab for COPD with Blood Eosinophil Evidence of Type 2 Inflammation","volume":"390","author":"Bhatt","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1056\/NEJMoa2303951","article-title":"Dupilumab for COPD with Type 2 Inflammation Indicated by Eosinophil Counts","volume":"389","author":"Bhatt","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1164\/rccm.202306-0944OC","article-title":"Ensifentrine, a Novel Phosphodiesterase 3 and 4 Inhibitor for the Treatment of Chronic Obstructive Pulmonary Disease: Randomized, Double-Blind, Placebo-Controlled, Multicenter Phase III Trials (the ENHANCE Trials)","volume":"208","author":"Anzueto","year":"2023","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.chest.2024.07.168","article-title":"Effect of Dual Phosphodiesterase 3 and 4 Inhibitor Ensifentrine on Exacerbation Rate and Risk in Patients with Moderate to Severe COPD","volume":"167","author":"Sciurba","year":"2025","journal-title":"Chest"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1186\/s12931-020-01512-y","article-title":"Efficacy and Safety of CHF6001, a Novel Inhaled PDE4 Inhibitor in COPD: The PIONEER Study","volume":"21","author":"Singh","year":"2020","journal-title":"Respir. Res."},{"key":"ref_99","first-page":"PA3923","article-title":"Late Breaking Abstract\u2014A Novel Macrolide, EP395, in Patients with Stable COPD: A RCT","volume":"64","author":"Watz","year":"2024","journal-title":"Eur. Respir. J."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1345\/aph.1D634","article-title":"The Effect of Clarithromycin on Inflammatory Markers in Chronic Obstructive Pulmonary Disease: Preliminary Data","volume":"38","author":"Basyigit","year":"2004","journal-title":"Ann. Pharmacother."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"102095","DOI":"10.1016\/j.pupt.2021.102095","article-title":"The Immunomodulatory Effects of Macrolide Antibiotics in Respiratory Disease","volume":"71","author":"Pollock","year":"2021","journal-title":"Pulm. Pharmacol. Ther."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/j.healun.2021.07.005","article-title":"Consensus Document for the Selection of Lung Transplant Candidates: An Update from the International Society for Heart and Lung Transplantation","volume":"40","author":"Leard","year":"2021","journal-title":"J. Heart Lung Transplant."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.healun.2019.03.009","article-title":"Chronic Lung Allograft Dysfunction: Definition, Diagnostic Criteria, and Approaches to treatment\u2015A Consensus Report from the Pulmonary Council of the ISHLT","volume":"38","author":"Verleden","year":"2019","journal-title":"J. Heart Lung Transplant."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1097\/MCP.0000000000001170","article-title":"The ABC of Transplant: ALAD, BLAD, and CLAD: Definition and Significance","volume":"31","author":"Verleden","year":"2025","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1164\/rccm.200212-1424BC","article-title":"Maintenance Azithromycin Therapy for Bronchiolitis Obliterans Syndrome: Results of a Pilot Study","volume":"168","author":"Gerhardt","year":"2003","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1097\/01.TP.0000122412.80864.43","article-title":"Azithromycin therapy for patients with bronchiolitis obliterans syndrome after lung transplantation","volume":"77","author":"Verleden","year":"2004","journal-title":"Transplantation"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1016\/j.healun.2004.08.006","article-title":"Long-Term Azithromycin Use for Treatment of Bronchiolitis Obliterans Syndrome in Lung Transplant Recipients","volume":"24","author":"Shitrit","year":"2005","journal-title":"J. Heart Lung Transplant."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1164\/rccm.200601-071OC","article-title":"Azithromycin Reduces Airway Neutrophilia and Interleukin-8 in Patients with Bronchiolitis Obliterans Syndrome","volume":"174","author":"Verleden","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/01.tp.0000295981.84633.bc","article-title":"Long-Term Azithromycin for Bronchiolitis Obliterans Syndrome After Lung Transplantation","volume":"85","author":"Gottlieb","year":"2008","journal-title":"Transplantation"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"E381","DOI":"10.1111\/j.1399-0012.2011.01435.x","article-title":"Clinical and Immunological Evaluation of 12-Month Azithromycin Therapy in Chronic Lung Allograft Rejection","volume":"25","author":"Federica","year":"2011","journal-title":"Clin. Transplant."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1097\/TP.0b013e3181a492b2","article-title":"Long-Term Clarithromycin Therapy in the Management of Lung Transplant Recipients","volume":"87","author":"Benden","year":"2009","journal-title":"Transplantation"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1136\/thoraxjnl-2014-205998","article-title":"A Randomised Controlled Trial of Azithromycin Therapy in Bronchiolitis Obliterans Syndrome (BOS) Post Lung Transplantation","volume":"70","author":"Corris","year":"2015","journal-title":"Thorax"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"e000465","DOI":"10.1136\/bmjresp-2019-000465","article-title":"Long-Term Effect of Azithromycin in Bronchiolitis Obliterans Syndrome","volume":"6","author":"Gan","year":"2019","journal-title":"BMJ Open Respir. Res."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1111\/ctr.12401","article-title":"Azithromycin Improves Lung Function in Patients with Post-lung Transplant Bronchiolitis Obliterans Syndrome: A Meta-analysis","volume":"28","author":"Kingah","year":"2014","journal-title":"Clin. Transplant."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.healun.2013.10.022","article-title":"A New Classification System for Chronic Lung Allograft Dysfunction","volume":"33","author":"Verleden","year":"2014","journal-title":"J. Heart Lung Transplant."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1183\/09031936.00068310","article-title":"A Randomised Controlled Trial of Azithromycin to Prevent Chronic Rejection after Lung Transplantation","volume":"37","author":"Vos","year":"2011","journal-title":"Eur. Respir. J."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/ajt.13417","article-title":"Prophylactic Azithromycin Therapy After Lung Transplantation: Post Hoc Analysis of a Randomized Controlled Trial","volume":"16","author":"Ruttens","year":"2016","journal-title":"Am. J. Transplant."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.healun.2018.12.006","article-title":"Azithromycin and Early Allograft Function after Lung Transplantation: A Randomized, Controlled Trial","volume":"38","author":"Frick","year":"2019","journal-title":"J. Heart Lung Transplant."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"e14832","DOI":"10.1111\/ctr.14832","article-title":"Early Onset of Azithromycin to Prevent CLAD in Lung Transplantation: Promising Results of a Retrospective Single Centre Experience","volume":"37","year":"2023","journal-title":"Clin. Transplant."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"e1495","DOI":"10.1097\/TXD.0000000000001495","article-title":"Decreased Lymphocytic Bronchitis Severity in the Era of Azithromycin Prophylaxis","volume":"9","author":"Santos","year":"2023","journal-title":"Transplant. Direct"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.healun.2019.11.007","article-title":"Influence of Azithromycin and Allograft Rejection on the Post\u2013Lung Transplant Microbiota","volume":"39","author":"Spence","year":"2020","journal-title":"J. Heart Lung Transplant."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1164\/rccm.202308-1326OC","article-title":"The Lung Microbiome Predicts Mortality and Response to Azithromycin in Lung Transplant Recipients with Chronic Rejection","volume":"209","author":"Combs","year":"2024","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.healun.2021.10.008","article-title":"Variability in Azithromycin Practices among Lung Transplant Providers in the International Society for Heart and Lung Transplantation Community","volume":"41","author":"Kapnadak","year":"2022","journal-title":"J. Heart Lung Transplant."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.bbmt.2014.12.001","article-title":"National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group Report","volume":"21","author":"Jagasia","year":"2015","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"00185","DOI":"10.1183\/23120541.00185-2022","article-title":"Bronchiolitis Obliterans Syndrome after Lung or Haematopoietic Stem Cell Transplantation: Current Management and Future Directions","volume":"8","author":"Glanville","year":"2022","journal-title":"ERJ Open Res."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1183\/09031936.05.00020804","article-title":"Azithromycin in Bronchiolitis Obliterans Complicating Bone Marrow Transplantation: A Preliminary Study","volume":"25","author":"Khalid","year":"2005","journal-title":"Eur. Respir. J."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1038\/bmt.2011.1","article-title":"Effects of Azithromycin in Bronchiolitis Obliterans Syndrome after Hematopoietic SCT\u2014A Randomized Double-Blinded Placebo-Controlled Study","volume":"46","author":"Lam","year":"2011","journal-title":"Bone Marrow Transplant."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s12185-015-1830-0","article-title":"The Efficacy of Prophylactic Azithromycin on Bronchiolitis Obliterans Syndrome after Hematopoietic Stem Cell Transplantation","volume":"102","author":"Jo","year":"2015","journal-title":"Int. J. Hematol."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1001\/jama.2017.9938","article-title":"Effect of Azithromycin on Airflow Decline\u2013Free Survival After Allogeneic Hematopoietic Stem Cell Transplant: The ALLOZITHRO Randomized Clinical Trial","volume":"318","author":"Bergeron","year":"2017","journal-title":"JAMA"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1016\/j.bbmt.2016.08.027","article-title":"Azithromycin for the Treatment of Obliterative Bronchiolitis after Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis","volume":"22","author":"Yadav","year":"2016","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.bbmt.2019.10.025","article-title":"Azithromycin Use and Increased Cancer Risk among Patients with Bronchiolitis Obliterans after Hematopoietic Cell Transplantation","volume":"26","author":"Cheng","year":"2020","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1038\/s41409-020-01073-0","article-title":"Azithromycin May Increase Hematologic Relapse Rates in Matched Unrelated Donor Hematopoietic Cell Transplant Recipients Who Receive Anti-Thymocyte Globulin, but Not in Most Other Recipients","volume":"56","author":"Sheshadri","year":"2021","journal-title":"Bone Marrow Transplant."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.bbmt.2015.10.009","article-title":"Fluticasone, Azithromycin, and Montelukast Treatment for New-Onset Bronchiolitis Obliterans Syndrome after Hematopoietic Cell Transplantation","volume":"22","author":"Williams","year":"2016","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"2301727","DOI":"10.1183\/13993003.01727-2023","article-title":"ERS\/EBMT Clinical Practice Guidelines on Treatment of Pulmonary Chronic Graft-versus-Host Disease in Adults","volume":"63","author":"Bos","year":"2024","journal-title":"Eur. Respir. J."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1513\/AnnalsATS.201604-262OC","article-title":"Lung Function Trajectory in Bronchiolitis Obliterans Syndrome after Allogeneic Hematopoietic Cell Transplant","volume":"13","author":"Cheng","year":"2016","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/S2213-2600(21)00017-5","article-title":"Early Diagnosis of Fibrotic Interstitial Lung Disease: Challenges and Opportunities","volume":"9","author":"Spagnolo","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12931-020-1275-8","article-title":"Azithromycin Has Enhanced Effects on Lung Fibroblasts from Idiopathic Pulmonary Fibrosis (IPF) Patients Compared to Controls","volume":"21","author":"Krempaska","year":"2020","journal-title":"Respir. Res."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/PL00021246","article-title":"Inhibitory Effects of 14-Membered Ring Macrolide Antibiotics on Bleomycin-Induced Acute Lung Injury","volume":"180","author":"Kawashima","year":"2002","journal-title":"Lung"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1038\/s41401-021-00618-3","article-title":"Roxithromycin Attenuates Bleomycin-Induced Pulmonary Fibrosis by Targeting Senescent Cells","volume":"42","author":"Zhang","year":"2021","journal-title":"Acta Pharmacol. Sin."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/1465-9921-7-16","article-title":"EM703 Improves Bleomycin-Induced Pulmonary Fibrosis in Mice by the Inhibition of TGF-\u03b2 Signaling in Lung Fibroblasts","volume":"7","author":"Li","year":"2006","journal-title":"Respir. Res."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"1800628","DOI":"10.1183\/13993003.00628-2018","article-title":"The Potential Impact of Azithromycin in Idiopathic Pulmonary Fibrosis","volume":"53","author":"Macaluso","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1513\/AnnalsATS.202103-266OC","article-title":"Azithromycin for the Treatment of Chronic Cough in Idiopathic Pulmonary Fibrosis: A Randomized Controlled Crossover Trial","volume":"18","author":"Guler","year":"2021","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_143","first-page":"201","article-title":"Effects of Broad-Spectrum Antimycobacterial Therapy on Chronic Pulmonary Sarcoidosis","volume":"30","author":"Drake","year":"2013","journal-title":"Sarcoidosis Vasc. Diffus. Lung Dis."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1001\/jamadermatol.2013.4646","article-title":"Oral Antimycobacterial Therapy in Chronic Cutaneous Sarcoidosis: A Randomized, Single-Masked, Placebo-Controlled Study","volume":"149","author":"Drake","year":"2013","journal-title":"JAMA Dermatol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"1902","DOI":"10.1016\/j.chest.2020.12.027","article-title":"Phase II Investigation of the Efficacy of Antimycobacterial Therapy in Chronic Pulmonary Sarcoidosis","volume":"159","author":"Drake","year":"2021","journal-title":"Chest"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"00534","DOI":"10.1183\/23120541.00534-2020","article-title":"Azithromycin for Sarcoidosis Cough: An Open-Label Exploratory Clinical Trial","volume":"6","author":"Fraser","year":"2020","journal-title":"ERJ Open Res."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1007\/s00408-024-00743-w","article-title":"Effects of Azithromycin on Blood Inflammatory Gene Expression and Cytokine Production in Sarcoidosis","volume":"202","author":"Fraser","year":"2024","journal-title":"Lung"},{"key":"ref_148","doi-asserted-by":"crossref","unstructured":"Radzikowska, E., Wiatr, E., Gawryluk, D., Langfort, R., Bestry, I., Rudzinski, P., Szczepulska-W\u00f3jcik, E., and Roszkowski-Sliz, K. Cryptogenic Organizing Pneumonia\u2014Results of Treatment with Clarithromycin versus Corticosteroids. Proceedings of In Proceedings of the European Respiratory Society International Congress 2016.","DOI":"10.1183\/13993003.congress-2016.PA3907"},{"key":"ref_149","first-page":"CD007716","article-title":"Macrolides for Diffuse Panbronchiolitis","volume":"2015","author":"Lin","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/S0954-6111(03)00042-8","article-title":"Long-Term Efficacy and Safety of Clarithromycin Treatment in Patients with Diffuse Panbronchiolitis","volume":"97","author":"Kadota","year":"2003","journal-title":"Respir. Med."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.2169\/internalmedicine.50.4727","article-title":"Effect of Azithromycin on Patients with Diffuse Panbronchiolitis: Retrospective Study of 51 Cases","volume":"50","author":"Li","year":"2011","journal-title":"Intern. Med."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"e00103-18","DOI":"10.1128\/mSphere.00103-18","article-title":"Impact of Long-Term Erythromycin Therapy on the Oropharyngeal Microbiome and Resistance Gene Reservoir in Non-Cystic Fibrosis Bronchiectasis","volume":"3","author":"Choo","year":"2018","journal-title":"mSphere"},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"e02246-21","DOI":"10.1128\/aac.02246-21","article-title":"Assessment of Long-Term Macrolide Exposure on the Oropharyngeal Microbiome and Macrolide Resistance in Healthy Adults and Consequences for Onward Transmission of Resistance","volume":"66","author":"Burr","year":"2022","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"e2220949","DOI":"10.1001\/jamanetworkopen.2022.20949","article-title":"Global Trends in the Proportion of Macrolide-Resistant Mycoplasma pneumoniae Infections: A Systematic Review and Meta-Analysis","volume":"5","author":"Kim","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"5077","DOI":"10.1021\/es062720x","article-title":"Occurrence of Pharmaceuticals in River Water and Their Elimination in a Pilot-Scale Drinking Water Treatment Plant","volume":"41","author":"Vieno","year":"2007","journal-title":"Environ. Sci. Technol."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"171996","DOI":"10.1016\/j.scitotenv.2024.171996","article-title":"Understanding Associations between Antimicrobial Agents Usage and Antimicrobial Resistance Genes Prevalence at the Community Level Using Wastewater-Based Epidemiology: A Spanish Pilot Study","volume":"926","author":"Bijlsma","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"121665","DOI":"10.1016\/j.watres.2024.121665","article-title":"Antimicrobials and Antimicrobial Resistance Genes in the Shadow of COVID-19 Pandemic: A Wastewater-Based Epidemiology Perspective","volume":"257","author":"Xu","year":"2024","journal-title":"Water Res."},{"key":"ref_158","doi-asserted-by":"crossref","unstructured":"Brown, L.P., Murray, R., Scott, A., Tien, Y.-C., Lau, C.H.-F., Tai, V., and Topp, E. (2022). Responses of the Soil Bacterial Community, Resistome, and Mobilome to a Decade of Annual Exposure to Macrolide Antibiotics. Appl. Environ. Microbiol., 88.","DOI":"10.1128\/aem.00316-22"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/11\/1061\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T01:23:56Z","timestamp":1761269036000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/11\/1061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":158,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["antibiotics14111061"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14111061","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]}}}