Macrolide therapy in cryptogenic organizing pneumonia: A case report and literature review

• Published in: Experimental and therapeutic medicine Vol. 9; no. 3; pp. 829 - 834
• Main Authors: DING, QUN-LI, LV, DAN, WANG, BI-JIONG, ZHANG, QIAO-LI, YU, YI-MING, SUN, SHI-FANG, CHEN, ZHONG-BO, MA, HONG-YING, DENG, ZAI-CHUN
• Format: Journal Article
• Language: English
• Published: Greece D.A. Spandidos 01.03.2015; Spandidos Publications; Spandidos Publications UK Ltd
• Subjects: Antibiotics; Asthma; azithromycin; Biopsy; Blood; Care and treatment; Case reports; Case studies; Clinical trials; Cryptogenic organizing pneumonia; Diagnosis; Disease; glucocorticoid; Health aspects; inflammation; Literature reviews; Lungs; macrolide; Macrolide antibiotics; Medical imaging; Neutrophils; organizing pneumonia; Patient outcomes; Patients; Pneumonia; Radiation therapy; Respiratory diseases; Risk factors; treatment; China; treatment; organizing pneumonia; glucocorticoid; azithromycin; inflammation; macrolide
• ISSN: 1792-0981; 1792-1015
• DOI: 10.3892/etm.2015.2183

Cryptogenic organizing pneumonia (COP) is a pulmonary disorder associated with nonspecific clinical presentations. The macrolide class of antimicrobial agents is widely used to treat infectious and inflammatory respiratory diseases in humans. The present study reports a case of COP that was effectively treated with azithromycin in combination with glucocorticoid. A literature review of similar cases is also presented. It was found that all COP patients in the literature received macrolide treatment, including six cases with unknown clinical outcomes. For the remaining 29 patients, 20 patients initially received the macrolide as a single therapy and 4/5 of them (16 cases) were cured with a treatment time of 3-14 months, while 1/5 (4 cases) showed no improvement after treatment for 1 month and were switched to a glucocorticoid or combination treatment with a glucocorticoid, after which the disease was finally well-controlled. Side-effects of macrolide were rare. Based on this analysis, it is recommended that macrolides can be used as a first-line therapy in patients with mild COP. For patients with recurrent COP, it is suggested that macrolides should be used as an adjunctive therapy with other treatments, such as a glucocorticoid.