Macrolides for chronic asthma

Macrolide antibiotics for treatment of asthma in adults: A meta-analysis of 18 randomized controlled clinical studies

“…Additionally, the results also found the prolonged macrolide antibiotics administration can improve the neutrophil and eosinophil cells count of sputum among Asian, but not in Caucasian. The following reasons may explained the different results when compared with Richeldi's [36] and Reiter's [37] studies: (1) More articles which came from different countries were included in our meta-analysis, and the present results might be more closer to the real values; (2) We corrected some statistics and data errors in the Reiter's meta-analysis, so our meta-analysis pooled results may reduced bias and errors; 3) To evaluate the ethnicity-specific effects, we performed a subgroup analysis by ethnicity group. The subgroup analysis results might indicated the macrolides have different functions with different ethnicities.…”

“…In 2005, Richeldi et al reported no significant difference on FEV1 in the patients with asthma for long-term macrolide administration, but there was significant difference in symptoms and inflammation cell counts in blood and sputum [36]. Unfortunately, only small number of included studies, so there is insufficient power to support or oppose the use of macrolides in asthma patients.…”

Different treatment benefits were estimated by clinical trials performed in adults compared with those performed in children

“…Twelve showed a benefit in children with a potential benefit in adults [23,24,33,42,51e53,55,85,88,90,98], whereas two showed a potential harmful effect for adults [69,85]. For three drugs, a harmful effect was shown for children with a potential harmful effect in adults [14,83,85], such as for phenobarbitone for treating convulsion in malaria which included infants from 9 months to 3 years old [74]. The small number of adult participants may explain the nonsignificant results of four meta-analyses.…”

Non–anti-infective Effects of Antimicrobials and Their Clinical Applications

“…37 A Cochrane review that included 7 studies concluded that there was insufficient evidence to support or refute evidence for the use of long-term macrolides in chronic asthma. 38 Macrolides and Use in Chronic Inflammatory Skin disorders Rosacea. The pathogenesis of rosacea is multifactorial.…”