Here’s a study showing that taking azithromycin can help to cut the rate of acute exacerbations in people with COPD. The anti-inflammatory properties of the macrolide antibiotics are well described. However, one thing that’s usually not addressed is the fact that the macrolides have anti-reflux properties. In general surgery, we used to give intravenous erythromycin to help speed gastric emptying after abdominal surgery. So by helping to empty the stomach faster, less juices are around to reflux up into the throat and then to the lungs. It’s important to realize that what comes up not only includes acid, but also stomach enzymes, bacteria and sometimes bile. Imagine even small amounts of these substances in your lungs.
Even if you don’t have significant obstructive sleep apnea, juices from your stomach can come up with any of the smaller obstructive events that aren’t classified as apneas or hypopneas. Not only do these same juices go into your lungs, it can also reach your nose and sinuses.