Longterm azithromycin therapy for three patients with chronic lower respiratory tract infections

Kasahara, Kei; Mikasa, Keiichi; Uno, Kenji; Takahashi, Kei; Konishi, Mitsuru; Yoshimoto, Eiichiro; Murakawa, K.; Kimura, Hiroshi; Kita, Eisuke; Maeda, Koichi

doi:10.1007/s10156-003-0280-4

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…To treat either pneumonia or chronic lung inflammations, AZ is administered by oral or parenteral routes. , These systemic routes, however, lead to off-target diffusion, poor bioavailability, and, consequently, higher doses to attain the necessary concentrations in the lung, especially in the epithelial lining fluid …”

Section: Introductionmentioning

confidence: 99%

“…11 To treat either pneumonia or chronic lung inflammations, AZ is administered by oral or parenteral routes. 4,12 These systemic routes, however, lead to off-target diffusion, poor bioavailability, and, consequently, higher doses to attain the necessary concentrations in the lung, especially in the epithelial lining fluid. 13 The inhalatory route constitutes a direct pathway to airways, which circumvents the problem of the poor penetration of intravenously administered antibiotics into lung parenchymal tissue and bronchial secretions.…”

Section: Introductionmentioning

confidence: 99%

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Fast Biofilm Penetration and Anti-PAO1 Activity of Nebulized Azithromycin in Nanoarchaeosomes

et al. 2019

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Introduction Azithromycin (AZ) is an azalide subclass of macrolide (a semi-synthetic 9-N-methylation derivative of erythromycin), with broad-spectrum antibiotic activity against gram-positive, gram-negative, and atypical bacterial infections that lead to pneumonia. 1,2 AZ is approved by the U.S. Food and Drug Administration (FDA) against pneumonia and chronic obstructive pulmonary disease exacerbations. 2 The in vivo effects of AZ combine antibacterial, bronchodilatation and importantly, anti-inflammatory activities (by supressing the activation of NF-kB and the synthesis of proinflammatory cytokines IL-6 and IL-8). 3 The use of AZ extends also to treat chronic lung diseases, where reducing the impact of infection, inflammation and subsequent tissue injury is of major importance. 4 AZ in particular, is administered against inflammatory recurrent chronic airways infections caused by Pseudomonas aeruginosa (Pa) 5,6 occurring in cystic fibrosis (CF) 7,8 , diffuse panbronchiolitis 9 and bronchiectasis. 10 Long-term treatment with AZ for instance, is included in the current guidelines for CF patients aged ≥ 6 years. 11 Either to treat pneumonia or chronic lung inflammations, AZ is administered by oral or parenteral routes. 12,4 These systemic routes, however, lead to off-target diffusion, poor bioavailability and, consequently, higher doses to attain the necessary concentrations in the lung, especially in the epithelial lining fluid. 13 The inhalatory route constitutes a direct pathway to airways, that circumvents the problem of the poor penetration of intravenously administered antibiotics into lung parenchymal tissue and bronchial secretions. It also provides a fast action onset, minimizing the access to circulation and therefore to the generation of unwanted systemic effect. 14 Indeed, different to the intravenous, the inhalatory route is compatible with chronic administration of medicines. 15 AZ moreover, has got poor gastric tolerability in the long term use. 16,17 In view of such circumstances, inhalable formulations of AZ are expected to improve current therapies against lung infections. The principal weakness of inhaled antibiotics against by Pa infections, however, is the low antibiotic exposure in the vicinity of biofilm colonies, a fact that results in diminished anti-pseudomonal efficacy after repeated uses. A suitable nanocarrier for AZ may help to overcome such drawbacks, because of their ability to modify drug's pharmacokinetics, biodistribution and pharmacodynamics (if needed), to selective and efficiently delivery drugs to diseased targets. To that aim however, nanocarriers structure must be tuned as a function of target site and administration route. 18 Not surprisingly, nanocarriers have started to attract interest as tools to improve the therapeutic index of inhalable antibiotics. Examples of that are the nebulized liposomal ciprofloxacins Pulmaquin and Lipoquin 19 , developed by Aradigm 20 , and Arikayce, a liposomal amikacin developed by Insmed. 21,22 Arikayce is the first and only medication app...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fast Biofilm Penetration and Anti-PAO1 Activity of Nebulized Azithromycin in Nanoarchaeosomes

et al. 2019

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“…Recently, such long-term therapy, employing several kinds of macrolides other than erythromycin (EM), such as clarithromycin (CAM) and azithromycin (AZM), has been applied to retard the progression of several other respiratory diseases, such as bronchial asthma, bronchiectasis, and cystic fibrosis; so far, the treatment is expected to confer a promising benefit for these patients. 2,3 However, the effects on microorganisms exerted by such long-term administration of antibiotics are of concern, although there have been very few reports on this issue. In the present study, we aimed to clarify whether LTMT has altered the sensitivity to antibiotics of Streptococcus pneumoniae.…”

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confidence: 99%

Macrolide resistance of Streptococcus pneumoniae isolated during long-term macrolide therapy: difference between erythromycin and clarithromycin

Kasahara

Kita

Maeda

et al. 2005

Journal of Infection and Chemotherapy

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Azithromycin-loaded respirable microparticles for targeted pulmonary delivery for the treatment of pneumonia

Wang

Hickey

et al. 2018

Biomaterials

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Longterm azithromycin therapy for three patients with chronic lower respiratory tract infections

Cited by 7 publications

References 10 publications

Fast Biofilm Penetration and Anti-PAO1 Activity of Nebulized Azithromycin in Nanoarchaeosomes

Fast Biofilm Penetration and Anti-PAO1 Activity of Nebulized Azithromycin in Nanoarchaeosomes

Macrolide resistance of Streptococcus pneumoniae isolated during long-term macrolide therapy: difference between erythromycin and clarithromycin

Azithromycin-loaded respirable microparticles for targeted pulmonary delivery for the treatment of pneumonia

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