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Azithromycin + budesonide is an investigational combination therapy being evaluated by Vanderbilt University Medical Center for the prevention and treatment of acute laryngeal injury (ALgI) in patients following prolonged endotracheal intubation. The regimen consists of azithromycin, a macrolide antibiotic with immunomodulatory properties that reduce mucosal airway inflammation, and budesonide, a potent inhaled corticosteroid that provides local anti-inflammatory effects. Preclinical evidence suggests that the two agents work synergistically to mitigate the inflammatory response and prevent the progression of acute injury to chronic airway fibrosis and ventilatory impairment. The therapy is currently being studied in a Phase 2 clinical trial (NCT03250975) involving ICU patients intubated for 24 hours to 7 days.
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