Clarithromycin attenuates mastectomy-induced acute inflammatory response

Area of Science:

• Surgical Oncology
• Pharmacology
• Immunology

Background:

• Surgical trauma triggers significant local and systemic inflammatory responses.
• Previous observations in a guinea pig model suggested clarithromycin attenuates inflammatory responses.
• The efficacy of clarithromycin in modulating post-mastectomy inflammation in humans required investigation.

Purpose of the Study:

• To evaluate the effects of clarithromycin on the inflammatory response in patients undergoing mastectomy.
• To assess the impact of clarithromycin on clinical outcomes, including pain and range of motion.

Main Methods:

• An open-label prospective study involving 54 patients undergoing mastectomy.
• Patients were randomized into two groups: one receiving oral clarithromycin (500 mg twice daily) perioperatively, and a control group.
• Data on inflammatory markers, pain, infection rates, and shoulder mobility were collected.

Main Results:

• Clarithromycin treatment significantly attenuated febrile response, tachycardia, and tachypnea.
• A significant increase in monocyte counts was observed in the clarithromycin group.
• Postoperative pain intensity and duration were reduced, and shoulder range of motion improved with clarithromycin use.
• No significant difference in antibiotic-related toxicities or postoperative infections was noted.

Conclusions:

• Clarithromycin effectively modulates the acute inflammatory response following mastectomy.
• Perioperative clarithromycin administration leads to improved clinical outcomes, including reduced pain and enhanced shoulder function.
• Clarithromycin represents a potential therapeutic option for managing post-surgical inflammation and improving patient recovery.