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Azithromycin in bronchiolitis obliterans complicating bone marrow transplantation: a preliminary study

¹ Section of Pulmonary Medicine, Dept of Medicine, and ² Section of Hematology/Bone Marrow Transplant, Dept of Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

CORRESPONDENCE: M. Khalid, Section of Pulmonary Medicine, Dept of Medicine, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia. Fax: 966 14427499. E-mail: mkhalid@kfshrc.edu.sa

Keywords: Allogeneic bone marrow transplant, azithromycin, bronchiolitis obliterans, macrolides, pulmonary function tests

Received: February 17, 2004
Accepted October 25, 2004

Bronchiolitis obliterans (BO) is a serious noninfectious pulmonary complication following allogeneic bone marrow transplantation (BMT). Azithromycin, a macrolide antibiotic, may have a beneficial effect in BO through its anti-inflammatory effect. The aim of the current study was to investigate the potential effect of azithromycin on pulmonary function tests (PFTs) in BO complicating BMT.

PFTs of 153 post-BMT patients were followed; eight patients out of 153 (12%) developed obstructive airway disease on their PFTs, along with characteristic findings of BO on high-resolution computed tomography of the chest. These patients were given azithromycin 500 mg q.d. for 3 days, followed by 250 mg three times a week for 12 weeks.

Clinically significant improvements were achieved both in forced vital capacity, where the mean (95% confidence interval) increase reported was 410 mL (0.16–0.65), which was an average improvement of 21.57%, and in the forced expiratory volume in one second, where the mean increase noticed was 280 mL (0.10–0.44), which was an average improvement of 20.58%.

In conclusion, the potential role of azithromycin in the treatment of bronchiolitis obliterans is intriguing and it warrants further testing.

This article has been cited by other articles:

				A. O. Soubani and J. P. Uberti Bronchiolitis obliterans following haematopoietic stem cell transplantation Eur. Respir. J., May 1, 2007; 29(5): 1007 - 1019. [Abstract] [Full Text] [PDF]

				D. H. Bryant Obliterative bronchiolitis in haematopoietic stem cell transplantation: can it be treated? Eur. Respir. J., March 1, 2005; 25(3): 402 - 405. [Full Text] [PDF]