This randomized controlled trial evaluates the therapeutic role of azithromycin in acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF). Baseline classification and randomization were guided by the SCALE-IPF framework (Severity Classification and Lung Evaluation for Prognosis in IPF; locked April 2023) to ensure balanced disease severity across arms. End-of-study analyses included descriptive phenotyping using the IPIM (Idiopathic Pulmonary Fibrosis Phenotypes Identification Model; locked August 2024). Both frameworks were developed within the Assiut University IPF Research Program (2022-2026), a coordinated institutional effort investigating clinical, prognostic, and therapeutic dimensions of IPF. Neither framework altered treatment allocation or endpoints; they were applied to improve standardization, reproducibility, and interpretability of results.