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Bronchiectasis and azithromycin 3 times a week.

Posted by rma1949 @rma1949, Dec 31, 2025

Is anyone trying azithromycin 3 times a week to try to stop recurring exacerbations of bronchiectasis from happening as often? My pulmonary doctor has suggested this. I’m a little leery because I don’t want to develop bacterial resistance from overuse. I currently use 14 days of amoxicillin when I have a bronchiectasis exacerbation.

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kathyhg | @kathyhg | 1 day ago
In reply to @scoop "@rma1949 I've cut and paste from the article "Bronchiectasis — A Clinical Review" from 2022 (from..." + (show)
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@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."

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@scoop I see from this article that macrolide monotherapy should not be used when an NTM infection is present. This is good information to have and appreciate you sharing this. Also, this rules out an ongoing antibiotic to prevent exacerbation for me.

I recently read a facebook discussion where someone said they take a German supplement called Angocin Anti-Infek (instead of a macrolide) on an ongoing basis to prevent exacerbations/infections. In one review, it was described as a good alternative to antibiotics.

I’d curious about whether anyone has more information on Angocin Anti-Infek and/or has anyone tried this? From what I read on the product description, the dosage is geared toward short term use for an active infection and not daily use to prevent infections. I’d appreciate any information about ongoing use of Angocin or any experience with it for short term use.

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tdel | @tdel | 11 hours ago

I am currently taking that antibiotic 3 times a week (M,W,F). It was originally thought that I had both bronchiectasis and MAC but 2 sputum tests never confirmed MAC. I was frequently picking up things from the grandkids causing flareups. I started taking the antibiotics in September and so far have avoided any flareups and tis the season. I'm coughing a lot less in general so hopefully this doesn't compromise me when I need a longer term antibiotic to kick my next infection.

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