Chronic respiratory diseases in some rabbits remain just that- chronic. sometimes antibiotics just not seem to have much of an effect.. hard to culture these rabbits with lower respiratory tract diseases, where many of the causative organisms live (in the lungs).. without anesthetizing the rabbit and doing a tracheal/lung wash, a culture is just as likely to show an unrelated bacteria as the organism causing the problem… and even if you did manage to come up with the right bacteria on a culture, that does not mean you will be able to clear the infections… rabbit lungs seem pretty effective in walling off infections (creating chronic abscesses) and even long term antibiotics do not seem to clear those up. Sometimes these rabbits just need to be kept on long term antibiotics (e.g. for years sometimes)
Azithromycin is a great antibiotic for certain lung infections but it is not the only one or necessarily the best.. and few studies have been done on rabbits to determine not only what dose to use, but how long to use it for.. .it is used frequently in people but generally for a strict 5 day treatment period. Not sure why longer treatment is not recommended, but there is likely a good reason for that.. and using it longer in rabbits may be doing more harm than good for all I know.