Long-term macrolide therapy in chronic inflammatory airway diseases.
In addition to direct antibacterial actions, 14- and 15-member-ring macrolides have immune modulating effects that appear to be the reason for clinical benefit in diffuse panbronchiolitis. A literature search was conducted for studies of the clinical effectiveness of macrolides in other chronic lung conditions. A number of studies were identified that showed short-term beneficial outcomes or the potential for such outcomes in cystic fibrosis, bronchiectasis, chronic obstructive pulmonary disease, asthma and post-transplant obliterative bronchiolitis. The studies were limited by small patient numbers, different outcome measures and short-term follow-up, and were not designed to assess potentially harmful effects. Further large prospective and long-term studies are required in order to identify potential benefit and harm before these agents can be recommended routinely for these conditions.
Crosbie
P A J
PA
Department of Respiratory Medicine, Manchester Royal Infirmary, Manchester, M13 9WL, UK.
Woodhead
M A
MA
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D016040:Lung Transplantation / Q000009:adverse effects; D018942:Macrolides / Q000008:administration & dosage* / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D018942:Macrolides