@article{RN506,
   author = {Pera, V. and Lepouttre, H. and Barboza, C. and Palomar-Cros, A. and López-Sánchez, I. and Duarte-Salles, T. and Rijnbeek, P. R. and Verhamme, K. M. C.},
   title = {Macrolide prescribing and preemptive electrocardiograms in asthma, COPD, ACO, and general population: a drug-utilization study},
   journal = {J Asthma},
   volume = {63},
   number = {2},
   pages = {249-262},
   note = {1532-4303
Pera, Victor
Orcid: 0000-0002-0786-4712
Lepouttre, Heleen
Barboza, Cesar
Orcid: 0009-0002-4453-3071
Palomar-Cros, Anna
Orcid: 0000-0001-8151-9290
López-Sánchez, Irene
Orcid: 0009-0001-5658-8945
Duarte-Salles, Talita
Orcid: 0000-0002-8274-0357
Rijnbeek, Peter R
Orcid: 0000-0003-0621-1979
Verhamme, Katia M C
Orcid: 0000-0001-8162-4904
Journal Article
England
2025/11/18
J Asthma. 2026 Feb;63(2):249-262. doi: 10.1080/02770903.2025.2589788. Epub 2025 Dec 1.},
   abstract = {OBJECTIVE: Macrolides are used in patients with chronic respiratory conditions to prevent exacerbations. However, due to their QT interval prolonging effect, an electrocardiogram (ECG) assessment prior to long-term treatment is recommended. The objective was to evaluate the incidence of macrolides use (azithromycin, clarithromycin, erythromycin) in individuals with asthma, chronic obstructive pulmonary disease (COPD), asthma-COPD overlap (ACO), and to assess the frequency of ECGs performed prior to long-term macrolide prescribing. METHODS: We utilized data from the Dutch Integrated Primary Care Information (IPCI) database and Spanish Information System for Research in Primary Care (SIDIAP), between 2006 and 2022. The study population consisted of individuals diagnosed with asthma, COPD, and ACO with ≥365 days follow-up after diagnosis. Incidence was analyzed by type of macrolide, database, year, and prescribing-duration (short-, medium-, long-term [<30, 30-179, ≥180 days]). RESULTS: SIDIAP included 224,783 individuals with asthma, 167,524 with COPD, and 34,475 with ACO, while IPCI included 66,383 with asthma, 26,805 with COPD, and 7250 with ACO. The incidence of short-term use per 100,000 person-years (PYs) was 3500-6700 for azithromycin, 1300-2100 for clarithromycin and 200-300 for erythromycin. The incidence of medium- and long-term use was less than <1100/100,000 PYs. Incidence rates were higher in SIDIAP, females, and 60-79 year-olds. Medium- and long-term use was 2- to 4-fold higher in COPD and ACO than asthma, and increased over time. Database-registered ECGs were found in less than 1% of long-term macrolide users. CONCLUSIONS: Long-term macrolide users were on the rise among COPD- and ACO individuals; however, ECG monitoring was rare, raising concerns given guideline recommendations.},
   keywords = {Humans
*Asthma/drug therapy
Female
Male
*Pulmonary Disease, Chronic Obstructive/drug therapy
Middle Aged
*Macrolides/therapeutic use/adverse effects/administration & dosage
*Electrocardiography/statistics & numerical data
Aged
Adult
*Anti-Bacterial Agents/therapeutic use/adverse effects
Erythromycin/therapeutic use
Clarithromycin/therapeutic use
Netherlands
*Practice Patterns, Physicians'/statistics & numerical data
Young Adult
Aco
Copd
Macrolides
asthma
electrocardiogram
prescriptions},
   ISSN = {0277-0903},
   DOI = {10.1080/02770903.2025.2589788},
   year = {2026},
   type = {Journal Article}
}

{"_id":"B7pse7oKs9ZFhGfqs","bibbaseid":"pera-lepouttre-barboza-palomarcros-lpezsnchez-duartesalles-rijnbeek-verhamme-macrolideprescribingandpreemptiveelectrocardiogramsinasthmacopdacoandgeneralpopulationadrugutilizationstudy-2026","author_short":["Pera, V.","Lepouttre, H.","Barboza, C.","Palomar-Cros, A.","López-Sánchez, I.","Duarte-Salles, T.","Rijnbeek, P. R.","Verhamme, K. M. C."],"bibdata":{"bibtype":"article","type":"Journal Article","author":[{"propositions":[],"lastnames":["Pera"],"firstnames":["V."],"suffixes":[]},{"propositions":[],"lastnames":["Lepouttre"],"firstnames":["H."],"suffixes":[]},{"propositions":[],"lastnames":["Barboza"],"firstnames":["C."],"suffixes":[]},{"propositions":[],"lastnames":["Palomar-Cros"],"firstnames":["A."],"suffixes":[]},{"propositions":[],"lastnames":["López-Sánchez"],"firstnames":["I."],"suffixes":[]},{"propositions":[],"lastnames":["Duarte-Salles"],"firstnames":["T."],"suffixes":[]},{"propositions":[],"lastnames":["Rijnbeek"],"firstnames":["P.","R."],"suffixes":[]},{"propositions":[],"lastnames":["Verhamme"],"firstnames":["K.","M.","C."],"suffixes":[]}],"title":"Macrolide prescribing and preemptive electrocardiograms in asthma, COPD, ACO, and general population: a drug-utilization study","journal":"J Asthma","volume":"63","number":"2","pages":"249-262","note":"1532-4303 Pera, Victor Orcid: 0000-0002-0786-4712 Lepouttre, Heleen Barboza, Cesar Orcid: 0009-0002-4453-3071 Palomar-Cros, Anna Orcid: 0000-0001-8151-9290 López-Sánchez, Irene Orcid: 0009-0001-5658-8945 Duarte-Salles, Talita Orcid: 0000-0002-8274-0357 Rijnbeek, Peter R Orcid: 0000-0003-0621-1979 Verhamme, Katia M C Orcid: 0000-0001-8162-4904 Journal Article England 2025/11/18 J Asthma. 2026 Feb;63(2):249-262. doi: 10.1080/02770903.2025.2589788. Epub 2025 Dec 1.","abstract":"OBJECTIVE: Macrolides are used in patients with chronic respiratory conditions to prevent exacerbations. However, due to their QT interval prolonging effect, an electrocardiogram (ECG) assessment prior to long-term treatment is recommended. The objective was to evaluate the incidence of macrolides use (azithromycin, clarithromycin, erythromycin) in individuals with asthma, chronic obstructive pulmonary disease (COPD), asthma-COPD overlap (ACO), and to assess the frequency of ECGs performed prior to long-term macrolide prescribing. METHODS: We utilized data from the Dutch Integrated Primary Care Information (IPCI) database and Spanish Information System for Research in Primary Care (SIDIAP), between 2006 and 2022. The study population consisted of individuals diagnosed with asthma, COPD, and ACO with ≥365 days follow-up after diagnosis. Incidence was analyzed by type of macrolide, database, year, and prescribing-duration (short-, medium-, long-term [<30, 30-179, ≥180 days]). RESULTS: SIDIAP included 224,783 individuals with asthma, 167,524 with COPD, and 34,475 with ACO, while IPCI included 66,383 with asthma, 26,805 with COPD, and 7250 with ACO. The incidence of short-term use per 100,000 person-years (PYs) was 3500-6700 for azithromycin, 1300-2100 for clarithromycin and 200-300 for erythromycin. The incidence of medium- and long-term use was less than <1100/100,000 PYs. Incidence rates were higher in SIDIAP, females, and 60-79 year-olds. Medium- and long-term use was 2- to 4-fold higher in COPD and ACO than asthma, and increased over time. Database-registered ECGs were found in less than 1% of long-term macrolide users. CONCLUSIONS: Long-term macrolide users were on the rise among COPD- and ACO individuals; however, ECG monitoring was rare, raising concerns given guideline recommendations.","keywords":"Humans *Asthma/drug therapy Female Male *Pulmonary Disease, Chronic Obstructive/drug therapy Middle Aged *Macrolides/therapeutic use/adverse effects/administration & dosage *Electrocardiography/statistics & numerical data Aged Adult *Anti-Bacterial Agents/therapeutic use/adverse effects Erythromycin/therapeutic use Clarithromycin/therapeutic use Netherlands *Practice Patterns, Physicians'/statistics & numerical data Young Adult Aco Copd Macrolides asthma electrocardiogram prescriptions","issn":"0277-0903","doi":"10.1080/02770903.2025.2589788","year":"2026","bibtex":"@article{RN506,\r\n author = {Pera, V. and Lepouttre, H. and Barboza, C. and Palomar-Cros, A. and López-Sánchez, I. and Duarte-Salles, T. and Rijnbeek, P. R. and Verhamme, K. M. C.},\r\n title = {Macrolide prescribing and preemptive electrocardiograms in asthma, COPD, ACO, and general population: a drug-utilization study},\r\n journal = {J Asthma},\r\n volume = {63},\r\n number = {2},\r\n pages = {249-262},\r\n note = {1532-4303\r\nPera, Victor\r\nOrcid: 0000-0002-0786-4712\r\nLepouttre, Heleen\r\nBarboza, Cesar\r\nOrcid: 0009-0002-4453-3071\r\nPalomar-Cros, Anna\r\nOrcid: 0000-0001-8151-9290\r\nLópez-Sánchez, Irene\r\nOrcid: 0009-0001-5658-8945\r\nDuarte-Salles, Talita\r\nOrcid: 0000-0002-8274-0357\r\nRijnbeek, Peter R\r\nOrcid: 0000-0003-0621-1979\r\nVerhamme, Katia M C\r\nOrcid: 0000-0001-8162-4904\r\nJournal Article\r\nEngland\r\n2025/11/18\r\nJ Asthma. 2026 Feb;63(2):249-262. doi: 10.1080/02770903.2025.2589788. Epub 2025 Dec 1.},\r\n abstract = {OBJECTIVE: Macrolides are used in patients with chronic respiratory conditions to prevent exacerbations. However, due to their QT interval prolonging effect, an electrocardiogram (ECG) assessment prior to long-term treatment is recommended. The objective was to evaluate the incidence of macrolides use (azithromycin, clarithromycin, erythromycin) in individuals with asthma, chronic obstructive pulmonary disease (COPD), asthma-COPD overlap (ACO), and to assess the frequency of ECGs performed prior to long-term macrolide prescribing. METHODS: We utilized data from the Dutch Integrated Primary Care Information (IPCI) database and Spanish Information System for Research in Primary Care (SIDIAP), between 2006 and 2022. The study population consisted of individuals diagnosed with asthma, COPD, and ACO with ≥365 days follow-up after diagnosis. Incidence was analyzed by type of macrolide, database, year, and prescribing-duration (short-, medium-, long-term [<30, 30-179, ≥180 days]). RESULTS: SIDIAP included 224,783 individuals with asthma, 167,524 with COPD, and 34,475 with ACO, while IPCI included 66,383 with asthma, 26,805 with COPD, and 7250 with ACO. The incidence of short-term use per 100,000 person-years (PYs) was 3500-6700 for azithromycin, 1300-2100 for clarithromycin and 200-300 for erythromycin. The incidence of medium- and long-term use was less than <1100/100,000 PYs. Incidence rates were higher in SIDIAP, females, and 60-79 year-olds. Medium- and long-term use was 2- to 4-fold higher in COPD and ACO than asthma, and increased over time. Database-registered ECGs were found in less than 1% of long-term macrolide users. CONCLUSIONS: Long-term macrolide users were on the rise among COPD- and ACO individuals; however, ECG monitoring was rare, raising concerns given guideline recommendations.},\r\n keywords = {Humans\r\n*Asthma/drug therapy\r\nFemale\r\nMale\r\n*Pulmonary Disease, Chronic Obstructive/drug therapy\r\nMiddle Aged\r\n*Macrolides/therapeutic use/adverse effects/administration & dosage\r\n*Electrocardiography/statistics & numerical data\r\nAged\r\nAdult\r\n*Anti-Bacterial Agents/therapeutic use/adverse effects\r\nErythromycin/therapeutic use\r\nClarithromycin/therapeutic use\r\nNetherlands\r\n*Practice Patterns, Physicians'/statistics & numerical data\r\nYoung Adult\r\nAco\r\nCopd\r\nMacrolides\r\nasthma\r\nelectrocardiogram\r\nprescriptions},\r\n ISSN = {0277-0903},\r\n DOI = {10.1080/02770903.2025.2589788},\r\n year = {2026},\r\n type = {Journal Article}\r\n}\r\n\r\n","author_short":["Pera, V.","Lepouttre, H.","Barboza, C.","Palomar-Cros, A.","López-Sánchez, I.","Duarte-Salles, T.","Rijnbeek, P. R.","Verhamme, K. M. C."],"key":"RN506","id":"RN506","bibbaseid":"pera-lepouttre-barboza-palomarcros-lpezsnchez-duartesalles-rijnbeek-verhamme-macrolideprescribingandpreemptiveelectrocardiogramsinasthmacopdacoandgeneralpopulationadrugutilizationstudy-2026","role":"author","urls":{},"keyword":["Humans *Asthma/drug therapy Female Male *Pulmonary Disease","Chronic Obstructive/drug therapy Middle Aged *Macrolides/therapeutic use/adverse effects/administration & dosage *Electrocardiography/statistics & numerical data Aged Adult *Anti-Bacterial Agents/therapeutic use/adverse effects Erythromycin/therapeutic use Clarithromycin/therapeutic use Netherlands *Practice Patterns","Physicians'/statistics & numerical data Young Adult Aco Copd Macrolides asthma electrocardiogram prescriptions"],"metadata":{"authorlinks":{}},"html":""},"bibtype":"article","biburl":"https://bibbase.org/network/files/qwipow2DJsAxqNp83","dataSources":["PcZMFHooKwpboi2he","jZMXEeHTfokmisJDv"],"keywords":["humans *asthma/drug therapy female male *pulmonary disease","chronic obstructive/drug therapy middle aged *macrolides/therapeutic use/adverse effects/administration & dosage *electrocardiography/statistics & numerical data aged adult *anti-bacterial agents/therapeutic use/adverse effects erythromycin/therapeutic use clarithromycin/therapeutic use netherlands *practice patterns","physicians'/statistics & numerical data young adult aco copd macrolides asthma electrocardiogram prescriptions"],"search_terms":["macrolide","prescribing","preemptive","electrocardiograms","asthma","copd","aco","general","population","drug","utilization","study","pera","lepouttre","barboza","palomar-cros","lópez-sánchez","duarte-salles","rijnbeek","verhamme"],"title":"Macrolide prescribing and preemptive electrocardiograms in asthma, COPD, ACO, and general population: a drug-utilization study","year":2026}