The Disease-Modifying Effects of Twice-Weekly Oral Azithromycin in Patients with Bronchiectasis

Cymbala, Alicia A; Edmonds, Lee C.; Bauer, Michael; Jederlinic, Peter J.; May, John J.; Victory, Jennifer; Amsden, Guy W.

doi:10.2165/00151829-200504020-00005

Cited by 129 publications

(99 citation statements)

References 21 publications

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“…Sputum volume in 24 h is a potentially useful marker as it is highly pertinent to the condition, noninvasive, easily accessible and inexpensive. It has been used as a marker in previous studies that have assessed potential long-term therapeutic strategies including inhaled steroids and long-term antibiotics [16][17][18][19][20][21]. A recent study has shown wet weight sputum to be as reliable as dry sputum [22].…”

Section: Discussionmentioning

confidence: 99%

Assessing response to treatment of exacerbations of bronchiectasis in adults

Murray¹,

Turnbull²,

MacQuarrie³

et al. 2008

Eur Respir J

112

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The present study aimed to assess the effect of intravenous antibiotic therapy on clinical and laboratory end-points in exacerbations of noncystic fibrosis bronchiectasis and to determine whether the outcomes were influenced by the pathogenic organism isolated.A prospective cohort study was conducted from November 2006 to March 2008 of exacerbations requiring intravenous antibiotics. End-points included 24-h sputum volume, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), incremental shuttle walk test, qualitative sputum microbiology, white cell count, erythrocyte sedimentation rate, C-reactive protein (CRP) and St George's Respiratory Questionnaire (SGRQ). Exacerbations due to Pseudomonas aeruginosa were compared with exacerbations due to other potential pathogenic organisms.In total, 32 exacerbations were studied. Following 14 days of intravenous antibiotics, all outcomes significantly improved independent of a pathogenic organism, except FEV1 and FVC. The most responsive markers were: 24-h sputum volume (reduced in all patients and 80% had o50% reduction); sputum bacterial clearance (78.1%); CRP (o75% reduction in 62.5%) and SGRQ (o4 unit improvement in 89.7%). CRP, 24-h sputum volume and SGRQ improved independent of microbial clearance.In the current study, 24-h sputum volume, microbial clearance, C-reactive protein and St George's Respiratory Questionnaire were the most useful parameters to assess response to treatment of exacerbations of bronchiectasis. Outcomes were similar independent of the pathogenic organism with the exception of forced expiratory volume in one second and forced vital capacity.

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Section: Discussionmentioning

confidence: 99%

Assessing response to treatment of exacerbations of bronchiectasis in adults

Murray¹,

Turnbull²,

MacQuarrie³

et al. 2008

Eur Respir J

112

View full text Add to dashboard Cite

show abstract

“…A reduction in bronchoalveolar lavage (BAL) fluid IL-8 concentration was seen in the treatment arm, but no change in pathogens or other measures of inflammation, including IL-10 and tumour necrosis factor-a, was measured. CYMBAALA et al [34] showed a reduction in sputum volume and infectious exacerbation frequency in adults (n511) treated with azithromycin in a randomised crossover study design. A quarter of the study population complained of diarrhoea as a side-effect of azithromycin treatment, with one individual withdrawing from the study.…”

Section: Bronchiectasismentioning

confidence: 99%

Long-term macrolide therapy in chronic inflammatory airway diseases

Crosbie¹,

Woodhead²

2008

Eur Respir J

120

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In addition to direct antibacterial actions, 14-and 15-member-ring macrolides have immune modulating effects that appear to be the reason for clinical benefit in diffuse panbronchiolitis.A literature search was conducted for studies of the clinical effectiveness of macrolides in other chronic lung conditions.A number of studies were identified that showed short-term beneficial outcomes or the potential for such outcomes in cystic fibrosis, bronchiectasis, chronic obstructive pulmonary disease, asthma and post-transplant obliterative bronchiolitis. The studies were limited by small patient numbers, different outcome measures and short-term follow-up, and were not designed to assess potentially harmful effects.Further large prospective and long-term studies are required in order to identify potential benefit and harm before these agents can be recommended routinely for these conditions.

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“…16,25,71 Los macrólidos pueden ser útiles a este fin. Cymbala et al señalan una disminución significativa de exacerbaciones respiratorias con azitromicina dos veces semanales durante 6 meses, 76 pero su uso no puede recomendarse sistemáticamente. 71 El tratamiento quirúrgico se reserva para bronquiectasias localizadas saculares o fusiformes con síntomas relevantes como retardo del crecimiento, broncorrea intensa, infecciones recurrentes, o hemoptisis intensa o repetida.…”

Section: Tratamientounclassified

Bronquiectasias en pediatría, aproximación diagnóstica y tratamiento

et al. 2012

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RESUMENLas bronquiectasias son un problema de salud en países desarrollados y en vías de desarrollo. La fibrosis quística es una causa importante, si bien fuera de ésta existen causas que convierten a las bronquiectasias no relacionadas con fibrosis quística en un diagnóstico frecuente. Su diagnóstico precoz basado en la clínica y posterior confirmación radiológica es el punto de partida para determinar la etiología e instaurar un tratamiento dirigido a la causa subyacente. Para ello es menester una evaluación ordenada y sistemá-tica. Se presenta una revisión sobre la etiología y tratamiento de las bronquiectasias, especialmente de las no relacionadas con fibrosis quística. Palabras clave: bronquiectasias, fibrosis quística, antibióticos, infección bronquial, diagnóstico. SUMMARYBronchiectasis is still an important health problem in both, developed and developing countries. Cystic fibrosis is one of the most important causes, but a great variety of other causes makes non cystic fibrosis bronchiectasis a relatively frequent diagnosis. Early diagnosis based on medical history and radiological confirmation is only the starting point to determine the specific etiology, in order to establish a treatment focused on the underlying cause. For this purpose, an orderly and systematic diagnostic evaluation is required. A review article about bronchiectasis, particularly those not related to cystic fibrosis, is presented.

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The Disease-Modifying Effects of Twice-Weekly Oral Azithromycin in Patients with Bronchiectasis

Cited by 129 publications

References 21 publications

Assessing response to treatment of exacerbations of bronchiectasis in adults

Assessing response to treatment of exacerbations of bronchiectasis in adults

Long-term macrolide therapy in chronic inflammatory airway diseases

Bronquiectasias en pediatría, aproximación diagnóstica y tratamiento

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