Role of Clarithromycin in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

The prevalence of chronic obstructive pulmonary disease (COPD) is increasing in under-developing and developing countries. As per current estimations, COPD will become the third leading cause of death globally, by 2030. Long-acting anti-cholinergic agents, β2-agonists, inhaled corticosteroids, antibiotics and mucolytics are few of the agents currently used in the treatment of COPD, which improve the symptoms and overall quality of life. Several of the important classes of antibiotics are used in the management of COPD including penicillins, cephalosporins, tetracyclines, fluoroquinolones, sulphonamides, aminoglycosides and macrolides. Macrolide antibiotics such as erythromycin, clarithromycin and azithromycin have a variety of physiological activities other than their antimicrobial effects, ultimately helping in preventing exacerbations and reducing mortality rates. Clinical studies indicate that long term use of clarithromycin is effective in the treatment of COPD exacerbations with lower incidence of adverse effects. This descriptive review on the role of the clarithromycin in treatment of COPD exacerbations will highlight these properties of clarithromycin in detail.