Clinical guidelines for diffuse panbronchiolitis therapy#
| Macrolides should be applied soon after the diagnosis is made, as there is a better clinical response in the earlier stage |
| First choice: erythromycin 400 or 600 mg orally |
| When it is no longer effective or if administration should be stopped because of adverse effects or drug interactions |
| Second choice: clarithromycin 200 or 400 mg orally or roxithromycin 150 or 300 mg orally¶ |
| Assessment of response and duration of treatment |
| Although clinical response can usually be noted within 2–3 months, the treatment should be continued for ≥6 months, after which time the overall response should be assessed |
| Treatment should be completed after a period of 2 yrs when clinical manifestations, radiological findings and pulmonary function measurements have improved and stabilised and without any significant impairment of daily activity |
| Treatment should be resumed if symptoms reappear after the cessation |
| In cases of an effective cure in advanced cases with extensive bronchiectasis or respiratory failure, treatment should be continued for >2 yrs |
#: developed by a working group of the Diffuse Lung Disease Committee of the Ministry of Health and Welfare of Japan 67; ¶: 16-member ring macrolides do not seem to be effective.