COPD flares, or exacerbations, can have a devastating effect on your health and your quality of life. And when they occur—sometimes without warning—they can be disabling, leading to trips to the emergency room or extended hospital stays, and, ultimately, accelerating the deterioration of your lungs.

Researchers now believe that some people are more likely to experience flares than others. Still, everyone with COPD can take steps to reduce his or her risk; this includes using medications as directed and making healthy choices—such as not smoking, getting vaccinated for the flu and pneumonia and avoiding triggers.

But even these steps can't guarantee protection. And sometimes it will be impossible to avoid situations that might trigger a flare, such as extreme changes in weather. Often, neither you nor your doctor will be able to identify exactly what triggered the flare. So how do you protect yourself against such an elusive enemy?

Some researchers believe a class of antibiotics known as macrolides may help. A recent study in The New England Journal of Medicine found that adding a daily dose of the macrolide antibiotic azithromycin (Zithromax) to the medications you're already taking for COPD can significantly reduce the risk of experiencing an acute exacerbation.

But there are important caveats as well: some of the known adverse effects associated with this treatment—and the potential for antibiotic resistance—may make this option too risky for some people to consider.

Power of Macrolides

Bacterial infections are a common trigger for COPD exacerbations, and antibiotics are often used to treat them. Antibiotics work against bacteria and can enhance your immune system's response by killing them, stopping them from multiplying, or interfering with how they attack your body's tissue.

But macrolide antibiotics also confer additional benefits. Most notably, they can reduce and help control both systemic and local inflammation. Inflammation is the result of your body's response to potentially harmful agents. However, inflammation, especially chronic inflammation, also damages normal tissue. Chronic inflammation is central to the development and progression of COPD and has been shown to be an independent risk factor for acute flare-ups.

Publication Review By: Peter B. Terry, M.D., M.A.

Published: 24 Jun 2013

Last Modified: 24 Jun 2013