[Study on azithromycin in treatment of diffuse panbronchiolitis]

Area of Science:

• Pulmonology
• Infectious Diseases
• Pharmacology

Background:

• Diffuse panbronchiolitis (DPB) is a chronic inflammatory lung disease.
• Established treatments for DPB include long-term, low-dose macrolide antibiotics like erythromycin and clarithromycin.
• Azithromycin (AZM), a 15-membered macrolide, offers a potential alternative treatment modality.

Purpose of the Study:

• To evaluate the efficacy and safety of intermittent azithromycin (AZM) administration in patients with diffuse panbronchiolitis (DPB).
• To compare the therapeutic effects of AZM with existing macrolide treatments for DPB.

Main Methods:

• A total of 60 DPB patients were enrolled; 52 were evaluated for efficacy and 55 for safety.
• AZM was administered intermittently at a dose of 250 mg, twice weekly, for a standard duration of 3 months.
• Clinical findings, including sputum volume, dyspnea, pulmonary function tests (vital capacity, FEV1.0), cold agglutination reaction, and C-reactive protein (CRP) levels, were assessed.

Main Results:

• An overall clinical efficacy rate of 84.6% (44/52) was observed.
• Significant improvements were noted in sputum volume (30/46), dyspnea on exertion (23/46), vital capacity (4/22), FEV1.0 (6/21), cold agglutination reaction (22/28), and CRP levels (16/36).
• Adverse reactions were infrequent (7.3%) and mild to moderate, including rash, itching, diarrhea, and gastric discomfort. Laboratory abnormalities were also mild.

Conclusions:

• Long-term, intermittent administration of azithromycin (AZM) is effective and safe for treating diffuse panbronchiolitis (DPB).
• AZM demonstrates comparable therapeutic effects to established 14-membered macrolides, suggesting its utility as an alternative treatment.
• The intermittent dosing regimen offers a potentially convenient and effective approach for managing DPB.