Roxithromycin Treatment in Patients with Chronic Lower Respiratory Tract Disease

Kadota, Jun‐ichi; Sakito, Osamu; Kohno, Shigeru; Abe, Koh; Shirai, Ryo; Kawakami, K.; Iida, Kei; Morikawa, Toru; Kusano, Shiro; Hara, Kohei

doi:10.11150/kansenshogakuzasshi1970.68.27

Cited by 17 publications

(17 citation statements)

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“…Recently, the efficacies of 14-membered ring macrolides (e.g., ERY, CAM, and RXM) and 15-membered ring macrolides (e.g., AZM) in the treatment of both DPB (3,6,13,17,19,20,22) and CF (1,29) were reported. These reports showed that macrolide therapy had little impact on the bacterial flora in the sputum, except in a few cases, but that these drugs may be effective even if the patient is already colonized with P. aeruginosa and that the prognosis is good regardless of P. aeruginosa infection (22).…”

Section: Discussionmentioning

confidence: 99%

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Effect of Erythromycin on Chronic Respiratory Infection Caused byPseudomonas aeruginosawith Biofilm Formation in an Experimental Murine Model

Nagata¹,

Mukae²,

Kadota

et al. 2004

Antimicrob Agents Chemother

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Diffuse panbronchiolitis (DPB) is a chronic lower respiratory tract infection commonly associated with persistent late-stage Pseudomonas aeruginosa infection. However, low-dose long-term therapy with certain macrolides is effective in most patients with DPB. The present study was designed to examine the effects of long-term erythromycin (ERY) therapy by using our established murine model of chronic respiratory P. aeruginosa infection. ERY or saline was administered from day 80 after intubation with a P. aeruginosaprecoated tube for the subsequent 10, 20, 40, and 80 days. Bacteriologic and histologic analyses of the murine lungs and electron microscopy of the intubated tube were performed. In the murine model, treatment with ERY for 80 days significantly reduced the number of viable P. aeruginosa organisms in the lungs (P < 0.05). The biofilm formed in situ by P. aeruginosa on the inner wall of the inoculation tube placed into the murine bronchus became significantly thinner after 80 days of ERY treatment. We conclude that the clinical efficacy of macrolides in DPB may be due at least in part to the reduction in P. aeruginosa biofilm formation.

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Section: Discussionmentioning

confidence: 99%

“…Several Japanese studies have demonstrated the therapeutic benefits of long-term therapy with macrolides, such as erythromycin (ERY), clarithromycin (CAM), roxithromycin (RXM), and azithromycin (AZM), in DPB patients (3,6,13,17,19,20,22). Recently, two studies from western countries demonstrated similar effects of AZM therapy in CF patients (1,29).…”

mentioning

confidence: 94%

Effect of Erythromycin on Chronic Respiratory Infection Caused byPseudomonas aeruginosawith Biofilm Formation in an Experimental Murine Model

Nagata¹,

Mukae²,

Kadota

et al. 2004

Antimicrob Agents Chemother

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“…The findings at lung biopsy and in the analysis of bronchoalveolar lavage fluid [15][16][17] do not clarify the real mechanism of treatment with low dose, longterm macrolide. Many changes have been reported as a consequence of erythromycin treatment, such as a decrease in the polymorphonuclear leukocyte-direct migration 18 , suppression of hypersecretion 19 , and a decreased percentage of activated T cells with the expression of HLA-DR in the peripheral blood of DPB patients 20 .…”

Section: Discussionmentioning

confidence: 99%

“…In spite of this, the use of low dose, long-term macrolide treatment figures as the one with large number of studies showing clinical, functional, and radiological improvement 8,16,[22][23][24] , as well as reduction in the mortality rate 25 .…”

Section: Discussionmentioning

confidence: 99%

Diffuse panbronchiolitis: an underdiagnosed disease? Study of 4 cases in Brazil

et al. 2002

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BACKGROUND: Diffuse panbronchiolitis is a clinical pathologic condition characterized by chronic inflammation of respiratory bronchioles, with clinical features that position it as a differential diagnosis among the sinopulmonary syndromes. METHODS AND RESULTS:We present 4 cases (1 Black, 2 Japanese descendants, and 1 Japanese), living in Brazil, in which the diagnosis was made by the clinical and radiological features and confirmed by transbronchial biopsy. The clinical findings included chronic sinusitis, productive cough, rhonchi, and wheezes. The pulmonary function tests showed an obstructive pattern. High resolution computerized tomography showed a diffuse nodular pattern, airway ectasia, and airway wall thickening. The biopsy showed interstitial accumulation of foam cells and lymphoid cells in the walls of respiratory bronchioles: 2 of our cases had bronchus-associated lymphoid tissue hyperplasia. We searched for the HLA Bw54 in all of our patients, but only 1 was positive. A low dose macrolide treatment was introduced, resulting in with clinical and functional improvement. A score that rated the extent of nodules, airway ectasia, mucus plugging, and airway wall thickening was applied on pre-and post-treatment High resolution computerized tomography results, revealing an improvement in tomographic pattern related to that observed in the pulmonary function tests.CONCLUSION: We conclude that diffuse panbronchiolitis is a systemic disease that is not exclusive to the Asian population, whose clinical and radiological features should be better known by occidental pulmonary physicians. DESCRIPTORS: Diffuse Panbronchiolitis. Bronchiolitis. Sinopulmonary syndromes. Interstitial lung disease. Bronchiolectasis.

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“…Erythromycin, a macrolide antibiotic, has been reported to be effective in treatment of patients with diffuse panbronchiolitis (DPB) and some chronic lower respiratory tract infections [1][2][3][4][5][6]. We tried lowdose long-term erythromycin therapy in a patient with diffuse bronchial amyloidosis.…”

Section: Introductionmentioning

confidence: 99%

Bronchial Amyloidosis Successfully Treated with Low-Dose Long-Term Erythromycin Therapy.

Nakahara¹,

Yano²,

Oshita³

et al. 1999

Kurume Med. J.

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Roxithromycin Treatment in Patients with Chronic Lower Respiratory Tract Disease

Abstract: IL-ƒÀ p<0.05). These cytokines showed a decrease after RXM treatment. These results indicated that RXM acts by reducing pulmonary inflammation through reduction of neutrophil migration to inflammatory sites, and is effective on chronic lower respiratory tract disease.

Cited by 17 publications

References 0 publications

Effect of Erythromycin on Chronic Respiratory Infection Caused byPseudomonas aeruginosawith Biofilm Formation in an Experimental Murine Model

Effect of Erythromycin on Chronic Respiratory Infection Caused byPseudomonas aeruginosawith Biofilm Formation in an Experimental Murine Model

Diffuse panbronchiolitis: an underdiagnosed disease? Study of 4 cases in Brazil

Bronchial Amyloidosis Successfully Treated with Low-Dose Long-Term Erythromycin Therapy.

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