Wednesday 16 September 2009

Prolonged usage of a macrolide antibiotic reduces COPD exacerbations


Prolonged usage of a macrolide antibiotic could possible minimize exacerbations in patients with moderate to severe COPD (chronic obstructive pulmonary disease) by as much as 35 percent as per a London-based study.
According to lead author of the paper, Terence A. R. Seemungal, Ph.D., and Jadwiga Wedzicha, M.D., principle investigator, there is a considerable effect of low-dose macrolide therapy, reducing exacerbation frequency, and severity with moderate to severe COPD.
From News-Medical.Net:
The researchers found that not only did the patients randomized to receive erythromycin have fewer exacerbations, but among the patients studied, 60 percent of the exacerbations that occurred were within the placebo group. While the number of exacerbation-related hospitalizations was small, more than twice as many occurred among the placebo group—14 versus 6. The median duration of exacerbations from onset to resolution of symptoms was 9 days in the erythromycin group and 13 days in the placebo group.
"Our results did not allow us to determine a mechanism for these findings. However based on in-vitro studies we suspect that the mechanism is likely to involve the anti-inflammatory properties of erythromycin," noted Dr. Seemungal.
While their findings are encouraging, Dr. Seemungal points out that they must be put in context with future findings. Furthermore, the threat of growing antibiotic resistance resulting from widespread prophylactic use of erythromycin is not a trivial concern. "In this scenario, substantial, widespread emergence of macrolide bacterial resistance is virtually foreordained, with attendant reduction in the antimicrobial usefulness of this drug class," wrote Ken M. Kunisaki, M.D. and Denise E. Niewoehner, M.D., of the Veterans Affairs Medical Center in Minneapolis, in the accompanying editorial. "Balancing benefit against harm could pose a dilemma for which there might be no clear answers."
John Heffner, M.D., past president of the ATS, was of the view that observations that intervention might possibly minimize the frequency and severity of acute exacerbations in COPD showcase present significant public health implications.

1 comment:

  1. I am not sure of the cause of COPD emphysema in my case. I smoked pack a day for 12 or 13 years, but quit 40 years ago. I have been an outdoor person all my adult life. Coughing started last summer producing thick mucus, greenish tint to clear. I tried prednisone and antibiotics, but no change. X-rays are negative, heart lungs and blood and serum chemistries all are normal. I have lung calcification from childhood bout with histoplasmosis. I am 75 years old and retired.My current doctor directed me to totalcureherbsfoundation com which I purchase the COPD herbal remedies from them ,they are located in Johannesburg, the herbal treatment has effectively reduce all my symptoms totally, am waiting to complete the 15 weeks usage because they guaranteed me total cure.

    ReplyDelete