@rma1949 I've cut and paste from the article "Bronchiectasis — A Clinical Review" from 2022 (from the ABCs of bronchiectasis thread) which describes the use of azithromycin. It can be quite beneficial in those with frequent exacerbations. When I was on it for bronchiectasis I noticed auditory side effects but it's difficult to pin this on that experience as I have been on my share of z-paks in my life. So might have been a cumulative effect.

"For patients with substantial daily symptoms and frequent exacerbations (three or more per year), additional therapies may be required to improve quality of life and prevent further lung damage. In a meta-analysis of three randomized trials, investigators found that the use of macrolide antibiotics reduced the frequency of exacerbations and increased the time until the next exacerbation. Improvements in quality of life were also documented in those trials. The mechanism of action is unclear, although macrolides may inhibit quorum sensing by P. aeruginosa. The usual dosing regimen is azithromycin at a dose of 500 mg three times per week or 250 mg daily. Although the studies were conducted for only 1 year, it seems that macrolides are generally safe and have an acceptable side-effect profile over longer durations. However, caution must be observed when prescribing macrolides, given the risk of resistance and gastrointestinal, cardiac, and auditory side effects. Macrolide monotherapy should not be used when nontuberculous mycobacterial infection is present or has not yet been ruled out."