Background Macrolide antibiotics have immunomodulatory activity and taken chronically reduce exacerbations of COPD. However, chronic use can cause bacterial resistance. EP395 (glasmacinal), a novel macrolide, is being developed as a treatment to reduce exacerbations of COPD without inducing antimicrobial resistance. Methods In this double-blind, placebo-controlled, Phase 2a trial (NCT05572333), patients (aged
