Background

Azithromycin (AZM) has shown in randomized clinical trials (RCTs) to reduce exacerbations in individuals with major chronic airway diseases. However, little is known about the trends in AZM use in real life.

Aim

Investigate trends in AZM prescribing among individuals with asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO) in the Integrated Primary Care Information (IPCI) database, a Dutch general practitioner database.

Methods

Study period was from 2012-2021. Inclusion criteria were: age ?18 years at diagnosis, ?1 year of database history prior to diagnosis and 1 year follow-up time (FUP). Incidence rate (IR) of AZM prescribing was calculated in individuals with newly diagnosed asthma (excl. COPD), COPD (excl. asthma) or ACO. Individuals were censored at 1 year FUP. The entire general population was used as reference with no restrictions.

Results

Overall, the highest IR was observed among ACO (Fig.1), followed by COPD and asthma. IR in the general population was on average 30-80% lower. The overall trend in IR was a decline, especially from 2018 onwards. Demographics are described in Table 1. IQR = Interquartile Range

Conclusion

AZM prescribing has decreased in the past years among individuals with major respiratory diseases and the general population.