NCT00563251 tested azithromycin for established bronchiolitis obliterans syndrome after hematopoietic stem-cell transplantation. This is treatment of an existing complication, not preventive antibiotic treatment in all transplant recipients. 123

The randomized, double-blind publication compared 10 participants receiving azithromycin 250 mg daily with 12 receiving placebo for 12 weeks. Lung-function testing and the St George’s Respiratory Questionnaire were used to assess response. The report did not find a significant treatment advantage. The published analysis population of 22 should not be replaced by the registry’s larger enrollment figure. 123

The small sample limits precision. The result does not establish that azithromycin benefits this condition and must not be merged with trials involving lung-transplant recipients or prophylaxis before bronchiolitis develops. 3