Azithromycin therapy for patients with bronchiolitis obliterans syndrome after lung transplantation.
BACKGROUND
Bronchiolitis obliterans syndrome (BOS) is the leading cause of late mortality after lung transplantation.


METHODS
We added azithromycin (AZI) (250 mg/day for 5 days, followed by 250 mg every other day) to the current immunosuppressive therapy in eight lung transplant recipients (mean age 36 years) with established BOS in an attempt to prevent further decline of the forced expiratory volume in 1 sec (FEV1).


RESULTS
Before the administration of AZI, there was a gradual decline of the FEV1 (-34.4%+/-14.7%) compared with the patients' best postoperative values. Twelve weeks after AZI had been added, there was a significant increase in the FEV1 (+18.3%+/-14.6%, P <0.0001, analysis of variance) with an absolute increase of 328+/-305 mL. This increase persisted in three patients during 9 months of follow-up.


CONCLUSIONS
AZI is a promising drug for some patients with BOS after lung transplantation. The exact mechanism of action is unknown at the present time.
Verleden
Geert M
GM
University Hospital Gasthuisberg, Department of Respiratory Medicine and Lung Transplantation Unit, Leuven, Belgium. geert.verleden@uz.kuleuven.ac.be
Dupont
Lieven J
LJ
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D001989:Bronchiolitis Obliterans / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005541:Forced Expiratory Volume; D006801:Humans; D016040:Lung Transplantation; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D017963:Azithromycin