The role of atypical infections and macrolide therapy in patients with asthma

For many years, the clinical benefit of macrolide use has been recognized in specific groups of patients with pulmonary disease. Dramatic improvement in survival of patients with diffuse panbronchiolitis is the most striking example of successful macrolide use as well as treatment of community acqui...

Full description

Saved in:
Bibliographic Details
Published inThe journal of allergy and clinical immunology in practice (Cambridge, MA) Vol. 2; no. 5; p. 511
Main Authors Rollins, Donald R, Good, Jr, James T, Martin, Richard J
Format Journal Article
LanguageEnglish
Published United States 01.09.2014
Subjects
Animals
Anti-Bacterial Agents - therapeutic use
Anti-Inflammatory Agents - therapeutic use
Asthma - drug therapy
Bacterial Infections - drug therapy
Drug Resistance, Bacterial
Humans
Macrolides - therapeutic use
Allergy
Airway evaluation
Macrolides
Asthma phenotype
Cytokine
Mycoplasma
Antibiotics and asthma
Viral infections
Asthma
Online AccessGet more information

Cover

More Information
Summary:For many years, the clinical benefit of macrolide use has been recognized in specific groups of patients with pulmonary disease. Dramatic improvement in survival of patients with diffuse panbronchiolitis is the most striking example of successful macrolide use as well as treatment of community acquired pneumonia caused by the atypical bacteria Mycoplasma, Chlamydophila, and Legionella. There also has been documentation of reduction in the exacerbation rate and of improvement in quality of life in patients with cystic fibrosis, bronchiectasis, chronic obstructive pulmonary disease, and reduction in post-lung transplantation bronchiolitis frequency. There has long been an interest in treating patients with severe asthma by using macrolides, but research results have not shown consistent clinical benefit in their use in the "general" population of patients with severe asthma. Rather, the successful use of macrolides seems to be in those patients with either documented Mycoplasma or Chlamydophila infection, or noneosinophilic asthma. Patients with neutrophil predominant phenotype severe asthma tend to show a decline in exacerbation rate, improved peak expiratory flows, and improved quality of life when treated with macrolides. This article will review the use of macrolides in the treatment of asthma.
ISSN:2213-2201
DOI:10.1016/j.jaip.2014.06.002