The pharmacodynamic profile of azithromycin against persistent strains of non-typeable H. influenzae (NTHi) from COPD patients was characterized. Azithromycin displayed differential concentration-dependent activity (R2 >0.98): pharmacodynamic response was attenuated comparing the 'first' vs. 'last' strain of NTHi which persisted in the airway of the same patient for 819 days (EC50 increased >50 times: 0.0821 mg/L vs. 4.23). In the Hollow Fiber Infection Model NTHi viability was maintained throughout simulated Zithromax Z-pak regimens over 10 days.
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