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There is currently a strong need to prevent exacerbations in patients with uncontrolled asthma. Gibson et al (Lancet 2017;390:659-68; http://ift.tt/2iVnMjL) performed a randomized, double-blind, placebo-controlled trial to assess the effect of the macrolide antibiotic azithromycin on asthma exacerbation frequency. Four hundred twenty patients with severe asthma that was uncontrolled by inhaled corticosteroids or long-acting bronchodilators were assigned to receive 500 mg of oral azithromycin or placebo 3 times per week for 48 weeks.

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