Azithromycin reduces acute flare-ups of chronic obstructive pulmonary disease (COPD). Researchers recruited 1,142 COPD patients from 17 facilities and randomized them to receive usual care plus either 250 mg of azithromycin or placebo for 12 months. The median time to the first acute exacerbation of COPD was 50% longer in the azithromycin group (266 days) than in the placebo group (174 days). The azithromycin group also had higher quality-of-life scores and less nasopharyngeal bacterial growth; however, the proportion of patients colonized with macrolide antibiotic-resistant microbes was higher in the treatment group. "Given the deleterious effects of acute exacerbations of COPD," write the authors in the August 25 New England Journal of Medicine, "adding azithromycin to the treatment regimen of patients who have had an acute exacerbation of COPD within the previous year or who require supplemental oxygen is a valuable option."