Abstract
Macrolide antibiotics possess a variety of actions other than antimicrobial activities. To determine the effects of long-term administration of clarithromycin (CAM) on the amount and physical properties of sputum in patients with clinical conditions associated with excessive airway secretions, we conducted the present study in a parallel, double-blind, placebo-controlled fashion. Patients were divided into two groups: the first group (n = 16) received CAM (100 mg, twice a day) for 8 weeks, and the second group (n = 15) received placebo. In evaluating airway secretion, the daily amount of expectorated sputum, solid composition, viscoelastic properties (including elastic modulus and dynamic viscosity), and sputum microbiology were assessed. CAM decreased sputum production from 51 +/- 6 to 24 +/- 3 g/day after treatment, whereas placebo had no effect. The bacterial density and sputum flora were unaltered. In the group receiving CAM, the percent solid composition and elastic modulus increased from 2.44% +/- 0.29% to 3.01% +/- 0.20% and 66 +/- 7 to 87 +/- 8 dyne/cm2 (P < 0.05), respectively, but the dynamic viscosity remained unchanged. These results suggest that long-term treatment with CAM reduces the amount of sputum production, probably by inhibiting airway secretions, and increases sputum elasticity.
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Selected References
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- Anderson R. Erythromycin and roxithromycin potentiate human neutrophil locomotion in vitro by inhibition of leukoattractant-activated superoxide generation and autooxidation. J Infect Dis. 1989 May;159(5):966–973. doi: 10.1093/infdis/159.5.966. [DOI] [PubMed] [Google Scholar]
- Annesi I., Kauffmann F. Is respiratory mucus hypersecretion really an innocent disorder? A 22-year mortality survey of 1,061 working men. Am Rev Respir Dis. 1986 Oct;134(4):688–693. doi: 10.1164/arrd.1986.134.4.688. [DOI] [PubMed] [Google Scholar]
- Goswami S. K., Kivity S., Marom Z. Erythromycin inhibits respiratory glycoconjugate secretion from human airways in vitro. Am Rev Respir Dis. 1990 Jan;141(1):72–78. doi: 10.1164/ajrccm/141.1.72. [DOI] [PubMed] [Google Scholar]
- Homma H., Yamanaka A., Tanimoto S., Tamura M., Chijimatsu Y., Kira S., Izumi T. Diffuse panbronchiolitis. A disease of the transitional zone of the lung. Chest. 1983 Jan;83(1):63–69. doi: 10.1378/chest.83.1.63. [DOI] [PubMed] [Google Scholar]
- Johnson N. T., Villalón M., Royce F. H., Hard R., Verdugo P. Autoregulation of beat frequency in respiratory ciliated cells. Demonstration by viscous loading. Am Rev Respir Dis. 1991 Nov;144(5):1091–1094. doi: 10.1164/ajrccm/144.5.1091. [DOI] [PubMed] [Google Scholar]
- Kadota J., Sakito O., Kohno S., Sawa H., Mukae H., Oda H., Kawakami K., Fukushima K., Hiratani K., Hara K. A mechanism of erythromycin treatment in patients with diffuse panbronchiolitis. Am Rev Respir Dis. 1993 Jan;147(1):153–159. doi: 10.1164/ajrccm/147.1.153. [DOI] [PubMed] [Google Scholar]
- Roche Y., Gougerot-Pocidalo M. A., Fay M., Forest N., Pocidalo J. J. Macrolides and immunity: effects of erythromycin and spiramycin on human mononuclear cell proliferation. J Antimicrob Chemother. 1986 Feb;17(2):195–203. doi: 10.1093/jac/17.2.195. [DOI] [PubMed] [Google Scholar]
- Rubin B. K., Ramirez O., Zayas J. G., Finegan B., King M. Collection and analysis of respiratory mucus from subjects without lung disease. Am Rev Respir Dis. 1990 Apr;141(4 Pt 1):1040–1043. doi: 10.1164/ajrccm/141.4_Pt_1.1040. [DOI] [PubMed] [Google Scholar]
- Shih C. K., Litt M., Khan M. A., Wolf D. P. Effect of nondialyzable solids concentration and viscoelasticity on ciliary transport of tracheal mucus. Am Rev Respir Dis. 1977 Jun;115(6):989–995. doi: 10.1164/arrd.1977.115.6.989. [DOI] [PubMed] [Google Scholar]
- Tamaoki J., Chiyotani A., Sakai N., Takeyama K., Takizawa T. Effect of erythromycin on ciliary motility in rabbit airway epithelium in vitro. J Antimicrob Chemother. 1992 Feb;29(2):173–178. doi: 10.1093/jac/29.2.173. [DOI] [PubMed] [Google Scholar]
- Tamaoki J., Isono K., Sakai N., Kanemura T., Konno K. Erythromycin inhibits Cl secretion across canine tracheal epithelial cells. Eur Respir J. 1992 Feb;5(2):234–238. [PubMed] [Google Scholar]
- Tschopp J. M., Turner-Warwick M. Persisting airflow limitation in asthmatics receiving routine self-adjusted medication. Eur J Respir Dis. 1984 Jul;65(5):346–353. [PubMed] [Google Scholar]