This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The objective of this proposal is to determine if chronic administration of a macrolide antibiotic will reduce the morbidity of COPD. This will be a prospective, randomized, double-blind, placebo-controlled clinical trial. A total of 1130 subjects at 7 clinical sites with at least moderately severe COPD will be randomized to either azithromycin 250mg every day or matching placebo. The rationale for this study is that the prevalence, morbidity, mortality and treatment costs of COPD are high and increasing. A large portion of the morbidity and costs are related to acute exacerbations. And macrolide antibiotics have a variety of antibacterial and antiinflammatory properties that in theory could reduce acute exacerbations
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