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Macrolides are commonly used in respiratory disease; they no doubt have an anti-inflammatory effect as well as their better-known bacteriostatic role. Three times a week prophylaxis seems to be a preferred regimen. Is there a role in cystic fibrosis in reducing inflammation and in turn reducing structural lung damage? Stick SM et al (Lancet Resp Medicine 2022; DOI: https://doi.org/10.1016/S2213-2600(22)00165-5) have hypothesised that azithromycin, given three times weekly to infants with cystic fibrosis from diagnosis until age 36 months, would reduce the extent of structural lung disease as captured on chest CT scans. This was a phase three, randomised, …
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