title: Role of long term antibiotics in chronic respiratory diseases.
abstract: Antibiotics are commonly used in the management of respiratory disorders such as cystic fibrosis (CF), non-CF bronchiectasis, asthma and COPD. In those conditions long-term antibiotics can be delivered as nebulised aerosols or administered orally. In CF, nebulised colomycin or tobramycin improve lung function, reduce number of exacerbations and improve quality of life (QoL). Oral antibiotics, such as macrolides, have acquired wide use not only as anti-microbial agents but also due to their anti-inflammatory and pro-kinetic properties. In CF, macrolides such as azithromycin have been shown to improve the lung function and reduce frequency of infective exacerbations. Similarly macrolides have been shown to have some benefits in COPD including reduction in a number of exacerbations. In asthma, macrolides have been reported to improve some subjective parameters, bronchial hyperresponsiveness and airway inflammation; however have no benefits on lung function or overall asthma control. Macrolides have also been used with beneficial effects in less common disorders such as diffuse panbronchiolitis or post-transplant bronchiolitis obliterans syndrome. In this review we describe our current knowledge the use of long-term antibiotics in conditions such as CF, non-CF bronchiectasis, asthma and COPD together with up-to-date clinical and scientific evidence to support our understanding of the use of antibiotics in those conditions.
authors.affiliation: Queen Alexandra Hospital, Respiratory Centre, C Level, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, UK. sureshbabu97@gmail.com
authors.forename: K
authors.initials: K
authors.lastname: Suresh Babu
authors.forename: J
authors.initials: J
authors.lastname: Kastelik
authors.forename: J B
authors.initials: JB
authors.lastname: Morjaria
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000188:drug therapy; D001987:Bronchiectasis / Q000150:complications / Q000188:drug therapy; D002908:Chronic Disease; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy; D006801:Humans; D018942:Macrolides / Q000008:administration & dosage / Q000627:therapeutic use; D009330:Nebulizers and Vaporizers; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy; D012141:Respiratory Tract Infections / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides