Long-term azithromycin may improve lung function in children with cystic fibrosis

Jaffé, Adam; Francis, Jackie; Rosenthal, Mark; Bush, Andrew

doi:10.1016/s0140-6736(05)78360-4

Cited by 265 publications

(135 citation statements)

References 5 publications

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“…Similar findings were reported for cystic fibrosis patients infected with P. aeruginosa (309)(310)(311), where improved lung function in children was seen following six to 15 months of azithromycin (AZM) treatment. This was an unexpected finding, considering the high levels of resistance that P. aeruginosa shows toward these drugs, and general anti-inflammatory effects associated with macrolides were suggested to account for the positive results (312).…”

Section: Antibiotics As Qs Inhibitorssupporting

confidence: 77%

Exploiting Quorum Sensing To Confuse Bacterial Pathogens

LaSarre

Federle

2013

Microbiol Mol Biol Rev

690

556

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SUMMARY Cell-cell communication, or quorum sensing, is a widespread phenomenon in bacteria that is used to coordinate gene expression among local populations. Its use by bacterial pathogens to regulate genes that promote invasion, defense, and spread has been particularly well documented. With the ongoing emergence of antibiotic-resistant pathogens, there is a current need for development of alternative therapeutic strategies. An antivirulence approach by which quorum sensing is impeded has caught on as a viable means to manipulate bacterial processes, especially pathogenic traits that are harmful to human and animal health and agricultural productivity. The identification and development of chemical compounds and enzymes that facilitate quorum-sensing inhibition (QSI) by targeting signaling molecules, signal biogenesis, or signal detection are reviewed here. Overall, the evidence suggests that QSI therapy may be efficacious against some, but not necessarily all, bacterial pathogens, and several failures and ongoing concerns that may steer future studies in productive directions are discussed. Nevertheless, various QSI successes have rightfully perpetuated excitement surrounding new potential therapies, and this review highlights promising QSI leads in disrupting pathogenesis in both plants and animals.

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Section: Antibiotics As Qs Inhibitorssupporting

confidence: 77%

Exploiting Quorum Sensing To Confuse Bacterial Pathogens

LaSarre

Federle

2013

Microbiol Mol Biol Rev

690

556

View full text Add to dashboard Cite

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“…For example, in vitro the combination of high concentrations of ceftazidime and gentamicin with rifampicin, which has little activity against the strains, led to the elimination of P. aeruginosa from biofilms [107]. Whether macrolides such as azithromycin [108] are effective has to be investigated in future multicentre studies. In vitro studies showed an inhibitory activity of macrolides on the production of alginate and other virulence factors of P. aeruginosa [109].…”

Section: Intravenous Antipseudomonal Antibiotic Therapy In Cystic Fibmentioning

confidence: 99%

Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus

Döring¹,

Conway²,

Heijerman³

et al. 2000

Eur Respir J

559

478

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Cystic fibrosis (CF) is the most common lethal hereditary disorder with autosomal recessive heredity in caucasians. The majority of CF patients suffer from chronic respiratory infection with the opportunistic bacterial pathogen Pseudomonas aeruginosa. No consensus among clinicians has been reached so far concerning antibiotic treatment against P. aeruginosa in CF patients.Consensus answers to 24 important questions in this context, based on current evidence, are presented, given by a panel of 34 European experts. Questions addressed and answered are: The diagnosis of P. aeruginosa lung colonization in CF; The impact of P. aeruginosa on the clinical state of CF patients; The assessment of P. aeruginosa susceptibility against antibiotics and the importance of these results for the clinician; The use of monotherapy versus combination therapy; The development of microbial resistance; The achievement of optimal airway concentrations; The effects of subinhibitory concentrations of antibiotics on P. aeruginosa; Statements on the pharmacokinetics of antibiotics in CF patients; Recommendations for doses and dosing intervals and length of treatment regimens; and Toxic side effects due to repeated antibiotic therapy was addressed.The expert panel answered further questions on the use of fluoroquinolones in children with CF, on the administration of nebulized antibiotics and whether prevention of P. aeruginosa lung colonization is possible in CF using antibiotic therapy.Problems of antibiotic therapy at home and in the hospital were addressed, a consensus statement on regular maintenance treatment, or treatment on demand, was given and different routes of administration of antibiotics were recommended for different clinical situations.Finally, the factors which determine the choice of the antibiotic, the dosage, and the duration of the treatment in cystic fibrosis patients were addressed and the design of future antibiotic studies in the context of Pseudomonas aeruginosa lung infection in cystic fibrosis patients were recommended. Eur Respir J 2000; 16: 749±767.

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“…The authors suggest that the observed effect must be related to the antiinflammatory activity of azithromycin and must be independent of its bactericidal action, as the blood levels were below the minimum inhibitory concentration. [32] Equi et al, [33] in a randomized, double-blind, prospective study, confirmed that treatment with azithromycin for 4-6 months in patients who do not adequately respond to the conventional therapy of cystic fibrosis was extremely beneficial for the pulmonary function, suggesting a possible antiinflammatory action of the drug.…”

Section: Discussionmentioning

confidence: 93%

Comparison of Azithromycin and Oral Hygiene Program in the Treatment of Cyclosporine-Induced Gingival Hyperplasia

Ramalho

Cipullo

et al. 2007

Renal Failure

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Background. It has been shown that azithromycin improves cyclosporine-induced gingival hyperplasia (GH), but its efficacy was never compared against an efficient oral hygiene program (OHP). The aim of this study was to analyze the effects of azithromycin plus OHP versus OHP alone in patients with cyclosporine-induced GH. Methods. After periodontal evaluation, 20 renal transplant recipients received detailed oral hygiene instructions and a complete OHP, and were randomized to control (OHP) or azithromycin groups (OHP plus azithromycin). Patients were re-evaluated after 15 and 30 days. Both groups were similar in time after transplant, age, gender, cyclosporine dose, and cyclosporine through level and serum creatinine. The control group had fewer patients using calcium cannel blockers (10% vs. 70%, p = 0.02). Results. All patients improved in pain, halitosis, and gum bleeding after OHP. The control group did not improve plaque index (PI) or GH. In contrast, baseline PI decreased from 1.52 ± 0.28 to 0.50 ± 0.16 on day 15 (p < 0.01) and to 0.46 ± 0.14 on day 30 (p < 0.01) in the azithromycin group, and the GH score decreased from 1.9 ± 0.27 to 0.90 ± 0.27 on day 15 (p < 0.05) and to 0.70 ± 0.21 on day 30 (p < 0.01). Conclusion. Azithromycin associated to efficient OHP induced a striking reduction in cyclosporine-induced GH, while efficient OHP alone improved oral symptoms but did not decrease cyclosporine-induced GH.

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Long-term azithromycin may improve lung function in children with cystic fibrosis

Cited by 265 publications

References 5 publications

Exploiting Quorum Sensing To Confuse Bacterial Pathogens

Exploiting Quorum Sensing To Confuse Bacterial Pathogens

Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus

Comparison of Azithromycin and Oral Hygiene Program in the Treatment of Cyclosporine-Induced Gingival Hyperplasia

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