Azithromycin to prevent COPD Exacerbations or not?

This is a nice review on azithromycin to prevent chronic obstructive pulmonary disease exacerbations (COPD exacerbations).

A recent Cochrane analysis and a retrospective VA study were both found that continuous azithromycin use decreased the incidence of COPD exacerbations in patients with mild-moderate COPD (OR 0.55).  However, azithromycin use did not improve quality of life and was associated with a slightly increased cardiovascular risk (by increasing the QT interval) and increased the risk of hearing loss.  See the link below for details:

http://pulmccm.org/main/2014/review-articles/azithromycin-for-copd-exacerbations-update-review/?art=1396632212&utm_source=Email+Updates+from+PulmCCM&utm_campaign=82c5fea24d-USP_mar_24_2014&utm_medium=email&utm_term=0_e9d9e09c7c-82c5fea24d-312068109

Do you think patients with COPD should be placed on continuous azithromycin?

References:

JAMA. 2014;311(21):2225-2226. doi:10.1001/jama.2014.4929.

Am J Respir Crit Care Med. 2014 May 15;189(10):1173-80. doi: 10.1164/rccm.201402-0385CI.

JAMA. 2014 Jun 4;311(21):2199-208. doi: 10.1001/jama.2014.4304.