Advertisement

Topics

Immunomodulatory Effects of Macrolide Antibiotics - Part 2: Advantages and Disadvantages of Long-Term, Low-Dose Macrolide Therapy.

Summary of "Immunomodulatory Effects of Macrolide Antibiotics - Part 2: Advantages and Disadvantages of Long-Term, Low-Dose Macrolide Therapy."

The available evidence for long-term, low-dose treatment with 14- and 15-membered ring macrolides in non-cystic fibrosis (CF) bronchiectasis, COPD, chronic sinusitis, and asthma is reviewed with special attention to possible adverse effects and the emergence of resistance during long-term macrolide treatment. Macrolide maintenance therapy has been proven to be of benefit in diffuse panbronchiolitis and CF, presumably due to an anti-inflammatory mechanism of action in addition to its direct antimicrobial effect. Solid evidence to justify this treatment regimen for non-CF bronchiectasis, asthma, or sinusitis is still lacking, although a beneficial effect of long-term macrolide therapy has been found in small clinical trials on these subjects. Data from randomized trials of long-term macrolide treatment in COPD are conflicting. A sufficiently long duration of treatment and the careful selection of patients appears to be crucial. Aside from its beneficial effects, possible side effects of macrolide treatment should be taken into account, the most important of these being gastrointestinal upset and cardiac arrhythmias. Development of macrolide resistance among respiratory pathogens is very common during long-term macrolide treatment. Whether this finding is clinically significant is a matter of debate.

Affiliation

Department of Pulmonary Diseases, Medical Centre Alkmaar, Alkmaar, The Netherlands.

Journal Details

This article was published in the following journal.

Name: Respiration; international review of thoracic diseases
ISSN: 1423-0356
Pages:

Links

DeepDyve research library

PubMed Articles [27369 Associated PubMed Articles listed on BioPortfolio]

Spectrophotometric Investigations of Macrolide Antibiotics: A Brief Review.

Macrolides, one of the most commonly used class of antibiotics, are a group of drugs produced by Streptomyces species. They belong to the polyketide class of natural products. Their activity is due to...

The Rate of Inducible MLSB Resistance in the Methicillin-Resistant Staphylococci Isolated From Clinical Samples.

Staphylococci are one of the most common pathogens in nasocomial and community-acquired infections. Methicillin-resistant staphylococci are known to be resistant against all beta-lactam antibiotics. T...

Intestinal microbiome is related to lifetime antibiotic use in Finnish pre-school children.

Early-life antibiotic use is associated with increased risk for metabolic and immunological diseases, and mouse studies indicate a causal role of the disrupted microbiome. However, little is known abo...

Russian Countermeasure Systems for Adverse Effects of Microgravity on Long-Duration ISS Flights.

The system of countermeasures for the adverse effects of microgravity developed in the USSR supported the successful implementation of long-duration spaceflight (LDS) programs on the Salyut and Mir or...

Update on the combination effect of macrolide antibiotics in community-acquired pneumonia.

Community-acquired pneumonia (CAP) is a leading cause of death from an infectious cause worldwide. Guideline-concordant antibiotic therapy initiated in a timely manner is associated with improved trea...

Clinical Trials [5049 Associated Clinical Trials listed on BioPortfolio]

Outcomes of Patients Not Responding to Antibiotics in the Community

A study to report the outcomes of patients who fail to respond to beta-lactam and macrolide antibiotics in the community

Macrolide Maintenance Therapy in Chronic Obstructive Pulmonary Disease (COPD)

To assess whether maintenance treatment with macrolide antibiotics in COPD patients with three or more exacerbations in the preceding year of inclusion can decrease the exacerbation rate i...

The Safety and Effectiveness of Rifabutin, Combined With Clarithromycin or Azithromycin, in HIV-Infected Patients

PER 03/10/94 AMENDMENT: PART B. To determine whether there is an effect on plasma drug levels of azithromycin and rifabutin as measured by changes in the plasma concentration-time curve (A...

Effectiveness of Azithromycin Therapy in Improvement of Symptoms and Lung Function in Patients With Bronchiolitis Obliterans After Bone Marrow Transplantation

Bronchiolitis obliterans syndrome (BOS), an obstructive airway disease as a result of chronic rejection, is one of the major causes of morbidity and mortality in long-term survivors of all...

Cognitive Effects of Immunomodulatory Drugs in MS

The purpose of this study is to examine and compare changes in the specific thinking skills of patients with RRMS who are receiving treatment with one of three immunomodulatory medications...

Medical and Biotech [MESH] Definitions

Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.

Nonsusceptibility of bacteria to the action of the beta-lactam antibiotics. Mechanisms responsible for beta-lactam resistance may be degradation of antibiotics by BETA-LACTAMASES, failure of antibiotics to penetrate, or low-affinity binding of antibiotics to targets.

Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.

Gases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration. (From AMA Drug Evaluations Annual, 1994, p173)

Monocyclic, bacterially produced or semisynthetic beta-lactam antibiotics. They lack the double ring construction of the traditional beta-lactam antibiotics and can be easily synthesized.

Quick Search
Advertisement
 


DeepDyve research library

Relevant Topics

Cystic Fibrosis
Affecting over 8,500 people in the UK, Cystic Fibrosis (CF) is one of the UK's most common life-threatening inherited diseases. Around half of the CF population can expect to live over 38 years, although improvements in treatments mean a baby born ...

COPD (chronic obstructive pulmonary disease)
COPD (chronic obstructive pulmonary disease) is used for a number of conditions including chronic bronchitis and emphysema, which all  lead to the airways in the lungs becoming damaged and thus narrower,  making inhalation and exhalation harder...

Asthma
Asthma is caused by inflammation of small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal.  When you come into contact with something that irritates your...


Searches Linking to this Article