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Macrolide antibiotics for cystic fibrosis

K W Southern1, P M Barker, A Solis

  • 1Child Health, University of Liverpool, Alder Hey Children's Hospital, Eaton Road, Liverpool, Merseyside, UK, L12 2AP.

The Cochrane Database of Systematic Reviews
|August 15, 2003
PubMed
Abstract

Insights

Macrolide antibiotics like azithromycin show short-term benefits for cystic fibrosis (CF) lung function, particularly FVC. However, their role in CF management remains unclear, and widespread use is not yet recommended.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Pharmacology

Background:

  • Cystic Fibrosis (CF) chest infections significantly impact patient outcomes.
  • Pseudomonas aeruginosa, a common CF pathogen, exhibits resistance to many oral antibiotics.
  • Macrolide antibiotics may offer indirect benefits against Pseudomonas aeruginosa.

Purpose of the Study:

  • To evaluate the efficacy of macrolide antibiotics in improving clinical status in CF patients compared to placebo or other antibiotics.
  • To assess the safety and adverse effects of macrolide antibiotic use in CF.
  • To determine optimal macrolide therapy parameters if benefits are demonstrated.

Main Methods:

  • Systematic review of published and unpublished randomized controlled trials (RCTs) of macrolide antibiotics in CF.
  • Searched Cochrane Cystic Fibrosis and Genetic Disorders Group trials register and contacted investigators for data.
  • Two RCTs involving 101 participants (adults and children) were included.

Main Results:

  • Azithromycin demonstrated small but significant improvements in forced vital capacity (FVC) at two months (WMD 5.42).
  • No significant differences were observed in forced expiratory volume in one second (FEV1).
  • No significant adverse effects were reported in the included studies.

Conclusions:

  • The clinical role of macrolides in managing CF lung disease requires further investigation.
  • Two small RCTs suggest short-term respiratory function improvements with azithromycin.
  • Widespread azithromycin use in CF is not currently advocated, pending results from larger, well-designed trials.

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