Macrolide antibiotics for cystic fibrosis

Southern, Kevin W; Barker, Pierre; Solís-Moya, Arturo; Patel, Latifa

doi:10.1002/14651858.cd002203.pub2

Cited by 68 publications

(26 citation statements)

References 43 publications

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“…Macrolides, especially azithromycin, are useful in the treatment of chronic bronchial colonization by P. aeruginosa in patients with bronchiectasis, mainly in cases associated with cystic fibrosis 7,32. Azithromycin interferes with production of virulence factors by P. aeruginosa , reduces biofilm formation by inhibiting alginate production, and decreases bacterial adherence 33.…”

Section: Discussionmentioning

confidence: 99%

“…Erythromycin is the most commonly used macrolide in diffuse panbronchiolitis, and obtains notable improvements in symptoms and survival. Studies in cystic fibrosis have mostly used azithromycin and have found improvement in lung function and a reduced exacerbation frequency 7,8. These effects are probably due to modulation of the inflammatory response and its ability to impede formation of biofilm 9.…”

Section: Introductionmentioning

confidence: 99%

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Long-term azithromycin therapy in patients with severe COPD and repeated exacerbations

Pomares¹,

Montón²,

Espasa³

et al. 2011

COPD

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BackgroundThe aim of this study was to determine whether long-term intermittent azithromycin therapy reduces the frequency of exacerbation in severe chronic obstructive pulmonary disease (COPD).MethodsWe retrospectively investigated the clinical benefits of long-term azithromycin (500 mg orally three times per week) over 12 months in patients with severe COPD and a minimum of four acute exacerbations (AECOPD) per year or chronic bronchial colonization by Pseudomonas aeruginosa, comparing the number of AECOPD, hospitalizations due to respiratory disease, days of hospital stay, and bacterial infections during azithromycin treatment and in the year prior to this therapy.ResultsTwenty patients who completed the 12-month treatment period were analyzed. No clinically significant adverse events were observed during azithromycin treatment. Compared with baseline data, azithromycin therapy significantly reduced the number of AECOPD (2.8 ± 2.5 versus 6.8 ± 2.8, P < 0.001), hospitalizations (1.4 ± 1.5 versus 3.6 ± 1.4, P < 0.001), and cumulative annual days of hospital stay (25 ± 32.2 versus 43.7 ± 21.4, P = 0.01). The improvement was particularly significant in patients with exacerbations caused by common potentially pathogenic microorganisms, who had 70% fewer AECOPD and hospitalizations. Patients colonized by P. aeruginosa had reductions of 43% in AECOPD and 47% in hospitalizations.ConclusionLong-term azithromycin is well tolerated and associated with significant reductions in AECOPD, hospitalizations, and length of hospital stay in patients with severe COPD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term azithromycin therapy in patients with severe COPD and repeated exacerbations

Pomares¹,

Montón²,

Espasa³

et al. 2011

COPD

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“…This anti-inflammatory effect has been demonstrated in in vitro models and in mice 69,70. A recently published meta-analysis demonstrated that the regular use of oral azithromycin shows a small, but significant, improvement in respiratory function at the 1- and 6-month points 71. Some studies also suggest a decrease in the number of exacerbations,67,72,73 and only one reported a significant increase in mild adverse events like nausea, diarrhea, and wheezing 67…”

Section: Antimicrobial Treatment In Clinical Practicementioning

confidence: 90%

Management of refractory Pseudomonas aeruginosa infection in cystic fibrosis

Sordé¹,

Pahissa²,

Rello³

2011

IDR

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Cystic fibrosis (CF) is the most common life-limiting inherited disease in Caucasian populations. The main cause of death in CF patients is respiratory failure resulting from chronic pulmonary infection. Pseudomonas aeruginosa is the most prevalent organism in the airway colonization of CF patients, and its persistence in the airways has been related to greater morbidity with a more rapid deterioration in lung function. P. aeruginosa has enormous genetic and metabolic flexibility that allows it to adapt and persist within the airways of CF patients, and it has the ability to easily acquire antimicrobial resistance. For these reasons, the management of infections and chronic colonization by P. aeruginosa remains a challenge for physicians. This article reviews the current and future antibacterial chemotherapy options for respiratory pseudomonal infection in CF patients.

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“…Erythromycin and clarithromycin have been successfully used to treat mucus hypersecretion in patients with bronchorrhea, asthma, and sinusitis [72]. Low dose and long term azithromycin therapy is now routinely used for the therapy of CF [73]. …”

Section: Reviewmentioning

confidence: 99%

Secretion properties, clearance, and therapy in airway disease

Rubin

2014

Transl Respir Med

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Chronic airway diseases like cystic fibrosis, chronic bronchitis, asthma, diffuse panbronchiolitis, and bronchiectasis are all associated with chronic inflammation. The airway mucosa responds to infection and inflammation in part by surface mucous (goblet) cell and submucosal gland hyperplasia and hypertrophy with mucus hypersecretion. Products of inflammation including neutrophil derived DNA and filamentous actin, effete cells, bacteria, and cell debris all contribute to mucus purulence and, when this is expectorated it is called sputum. Mucus is usually cleared by ciliary movement, and sputum is cleared by cough.These airway diseases each are associated with the production of mucus and sputum with characteristic composition, polymer structure, and biophysical properties. These properties change with the progress of the disease making it possible to use sputum analysis to identify the potential cause and severity of airway diseases. This information has also been important for the development of effective mucoactive therapy to promote airway hygiene.

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Macrolide antibiotics for cystic fibrosis

Cited by 68 publications

References 43 publications

Long-term azithromycin therapy in patients with severe COPD and repeated exacerbations

Long-term azithromycin therapy in patients with severe COPD and repeated exacerbations

Management of refractory Pseudomonas aeruginosa infection in cystic fibrosis

Secretion properties, clearance, and therapy in airway disease

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