
    slow recruitment
  
['chronic obstructive pulmonary disease']
['azithromycin', 'placebo']

        Inclusion Criteria:

          -  Established diagnosis of COPD by medical doctor (based on clinical history OR
             pulmonary function test)

          -  Smoking history of at least 10 pack-years (10 pack-years are defined as 20 cigarettes
             a day for 10 years, or 10 cigarettes a day for 20 years, etc.)

          -  Current hospitalization for potential infectious AECOPD treated with standard therapy

          -  History of at least one exacerbation during the last year (prior to the current
             hospital admission) for which systemic steroids and/or antibiotics were taken

          -  ECG at admission

        Exclusion Criteria:

          -  Mechanical or non-invasive ventilation at moment of randomization (D1)

          -  Long QT interval on ECG (QTc > 450msec for males or > 470msec for females)

          -  History of life-threatening arrhythmias

          -  Myocardial infarction (NSTEMI or STEMI) less than 6 weeks before start of study drug

          -  Unstable angina pectoris or acute myocardial infarction (NSTEMI or STEMI) at admission

          -  Drugs with high risk for long QT interval and torsade de pointes (amiodarone,
             flecainide, procainamide, sotalol, droperidol, haldol, citalopram, other macrolides)

          -  Documented uncorrected severe hypokalemia (K+ < 3.0 mmol/L) or hypomagnesemia (Mg2+ <
             0.5 mmol/L)

          -  Chronic systemic steroids (> 4 mg methylprednisolone /day for ≥ 2 months)

          -  Actual use of macrolides for at least 2 weeks

          -  Allergy to macrolides

          -  Active cancer treatment

          -  Life expectancy < 3 months

          -  Pregnant or breast-feeding subjects. Woman of childbearing potential must have a
             pregnancy test performed and a negative result must be documented before start of
             treatment
      