title: Macrolide antibiotics for treatment of asthma in adults: a meta-analysis of 18 randomized controlled clinical studies.
abstract: Mounting studies have been showed that long-term macrolides used in patients with asthma could improve the lung function and symptoms. However, a large number of studies have reported inconclusive results. The aim of this meta-analysis was to investigate the effect of macrolide antibiotics in patients with asthma. We have performed a search in PubMed, Embase, China National Knowledge Internet (CNKI), and Wanfang databases. The weighed mean difference (WMD) or standardized mean difference (SMD) was used to evaluate the pooled effect. Statistical analysis was performed by STATA 11.0 software. Totally 1306 patients were included in the meta-analysis. The overall results indicated that statistically significance of long-term macrolides therapy in patients with asthma on forced expiratory volume in 1 s (FEV1) (WMD: 0.11, P < 0.01), peak expiratory flow (PEF) (SMD: 0.25, P = 0.001), airway hyper-responsiveness (AHR) (SMD: 0.90, P = 0.04), forced vital capacity (FVC) (WMD: 0.18, P = 0.05) and FEV1/FVC (WMD: 1.93, P < 0.001), but no statistically significance on FEV1/predict, FVC/predict, symptom scores, quality of life scores (QOL), reliever inhaler puffs per 24 h, and cell counts in sputum and blood. The subgroup analysis indicated macrolides could increase FEV1 and PEF in Caucasian and Asian, decrease AHR in Caucasian, while cells counts of sputum improvement among Asian. Therefore, the study suggested that long-term marolides therapy in asthma may improved the FEV1, PEF, AHR, FVC, FEV1/FVC and cells counts in sputum, but it can't improve other lung function (FEV1/predict and FVC/predict) and clinical outcomes (such as symptom, quality of life etc.).
authors.affiliation: Department of Respiratory Medicine and Critical Care Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Tong
authors.affiliation: The Second Affiliated Hospital of Chonqing Medical University, Chongqing 404100, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Guo
authors.affiliation: Department of Respiratory Medicine and Critical Care Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Sitong
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Respiratory Medicine and Critical Care Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Shifeng
authors.initials: S
authors.lastname: Peng
authors.affiliation: Department of Respiratory Medicine and Critical Care Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Zhipeng
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Department of Respiratory Medicine and Critical Care Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yang
authors.affiliation: The Periodical Press of West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. Electronic address: yonggang-zhang@sohu.com.
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine and Critical Care Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. Electronic address: fanhongfanscu@sina.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Fan
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology; D016535:Bronchial Hyperreactivity; D004804:Eosinophils / Q000378:metabolism; D005541:Forced Expiratory Volume; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use*; D009504:Neutrophils / Q000378:metabolism; D010366:Peak Expiratory Flow Rate; D013183:Sputum / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides
keywords: Asthma; Lung function; Macrolide; Meta-analysis