The Effect of Clarithromycin on Inflammatory Markers in Chronic Obstructive Pulmonary Disease: Preliminary Data

Başyiğit, İlknur; Yıldız, Füsun; Özkara, Sevgiye Kaçar; Yıldırım, Elif; Boyacı, Haşim; Ilgazlı, Ahmet

doi:10.1345/aph.1d634

Cited by 60 publications

(40 citation statements)

References 26 publications

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“…airway inflammation [36]. Previous studies [36,37] demonstrated that one of the anti-inflammatory mechanisms of macrolides relates to the inhibition of IL-8 production.…”

Section: Discussionmentioning

confidence: 99%

Clarithromycin in the treatment of RSV bronchiolitis: a double-blind, randomised, placebo-controlled trial

Tahan¹,

Özcan²,

Koç³

2006

European Respiratory Journal

101

130

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Respiratory syncytial virus (RSV) bronchiolitis is the most common lower respiratory tract infection in infancy. To date, there is no effective therapy for RSV bronchiolitis.In order to investigate the efficacy of clarithromycin in the treatment of RSV bronchiolitis, the present authors conducted a randomised, double-blind, placebo-controlled trial comparing clarithromycin with placebo in 21 infants with a diagnosis of RSV bronchiolitis. The infants were randomised to receive clarithromycin or placebo daily for 3 weeks. Levels of interleukin (IL)-4, IL-8, eotaxin, and interferon-c were determined in plasma, before and after treatment, using ELISA. Six months after treatment, parents were surveyed as to whether their child had experienced wheezing within the previous 6 months.Treatment with clarithromycin was associated with a statistically significant reduction in the length of hospital stay, the duration of need for supplemental oxygen and the need for b 2 -agonist treatment. There were significant decreases in plasma IL-4, IL-8 and eotaxin levels after 3 weeks of treatment with clarithromycin. Readmission to the hospital within 6 months after discharge was significantly lower in the clarithromycin group.In conclusion, clarithromycin has statistically significant effects on the clinical and laboratory findings in respiratory syncytial virus bronchiolitis. Therefore, clarithromycin treatment may be helpful in reducing the short-term effects of respiratory syncytial virus bronchiolitis.

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“…airway inflammation [36]. Previous studies [36,37] demonstrated that one of the anti-inflammatory mechanisms of macrolides relates to the inhibition of IL-8 production.…”

Section: Discussionmentioning

confidence: 99%

Clarithromycin in the treatment of RSV bronchiolitis: a double-blind, randomised, placebo-controlled trial

Tahan¹,

Özcan²,

Koç³

2006

European Respiratory Journal

101

130

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“…In addition to their antimicrobial activity, macrolides are believed to have antiinflammatory effects, which could be especially advantageous in AECOPD. [12][13][14] In trials of chronic bronchitis, however, fluoroquinolones have been shown to reduce the risk of recurrent exacerbation when compared to macrolides. 15 The wide variation that has been observed in antibiotic selection for patients hospitalized for AECOPD suggests a high degree of uncertainty among clinicians about the benefits of different treatment options.…”

mentioning

confidence: 99%

Comparative effectiveness of macrolides and quinolones for patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD)

Rothberg

Pekow

Lahti

et al. 2010

Journal of Hospital Medicine

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BACKGROUND: Meta‐analyses of randomized trials have found that antibiotics are effective in acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but there is insufficient evidence to guide antibiotic selection. Current guidelines offer conflicting recommendations. OBJECTIVE: To compare the effectiveness of macrolides and quinolones for AECOPD DESIGN: Retrospective cohort study using logistic regression, propensity score–matching, and grouped treatment models. SETTING: A total of 375 acute care hospitals throughout the United States. PATIENTS: Age ≥40 years and hospitalized for AECOPD. INTERVENTION: Macrolide or quinolone antibiotic begun in the first 2 hospital days. MEASUREMENTS: Treatment failure (defined as the initiation of mechanical ventilation after hospital day 2, inpatient mortality, or readmission for AECOPD within 30 days), length of stay, and hospital costs. RESULTS: Of the 19,608 patients who met the inclusion criteria, 6139 (31%) were treated initially with a macrolide and 13,469 (69%) with a quinolone. Compared to patients treated initially with a quinolone, those who received macrolides had a lower risk of treatment failure (6.8% vs. 8.1%; P < 0.01), a finding that was attenuated after multivariable adjustment (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.78–1.01), and disappeared in a grouped‐treatment analysis (OR, 1.01; 95% CI, 0.75–1.35). There were no differences in adjusted length of stay (ratio, 0.98; 95% CI, 0.97–1.00) or adjusted cost (ratio, 1.00; 95% CI, 0.99–1.02). After propensity score–matching, antibiotic‐associated diarrhea was more common with quinolones (1.2% vs. 0.6%; P < 0.001). CONCLUSIONS: Macrolide and quinolone antibiotics are associated with similar rates of treatment failure in AECOPD; however, macrolides are less frequently associated with diarrhea. Journal of Hospital Medicine 2010;5:267–267. © 2010 Society of Hospital Medicine.

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“…Another group investigated the effects of clarithromycin on inflammatory markers in 30 men with mild to moderate COPD, who were not on corticosteroids, in a double-blind, placebo-controlled study. 60 They documented significant decreases in sputum total cell count, lL-8 and TNF levels, with similar decreases in serum inflammatory markers.…”

Section: Use Of Macrolides In Patients With Copdmentioning

confidence: 86%

Non-antimicrobial activity of macrolides: therapeutic potential in chronic inflammatory airway disorders

Feldman

Anderson²

2009

Southern African Journal of Epidemiology and Infection

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The Effect of Clarithromycin on Inflammatory Markers in Chronic Obstructive Pulmonary Disease: Preliminary Data

Cited by 60 publications

References 26 publications

Clarithromycin in the treatment of RSV bronchiolitis: a double-blind, randomised, placebo-controlled trial

Clarithromycin in the treatment of RSV bronchiolitis: a double-blind, randomised, placebo-controlled trial

Comparative effectiveness of macrolides and quinolones for patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD)

Non-antimicrobial activity of macrolides: therapeutic potential in chronic inflammatory airway disorders

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