Abstract
Introduction: Corticosteroids are the first line of therapy recommended in organizing pneumonia(OP). However, cases of response to the macrolide immunomodulatory properties prescribed after intolerance or steroids inefficacy have been reported.
Aims: To identify and to characterize patients with diagnosis of OP treated with macrolides and to analyze the potential of macrolide therapy as an alternative or adjuvant treatment in this context
Methods: Retrospective study of patients diagnosed with OP (cryptogenic and secondary) followed in a tertiary hospital who were treated with macrolides. The macrolide prescription protocol included a dose of azithromycin 500 mg 3x per week for 2 years, prescribed after relapse, contraindication or intolerance to systemic corticosteroid (SC)
Results: We included 13 patients with a mean age of 64.1 ± 11.7 years, predominantly female(n=9) and non-smokers(n=9). In more than half of patients a cause for OP was identified (drugs n=7;immunodeficiency n=2;connectivitis n=1). As 1st line therapy, 85% (n=11) of patients were treated with SC and 15% (n=2) with azithromycin because of relative contraindications. Azithromycin was prescribed in 10 patients previously on SC after disease relapse and in 1 patient after intolerance. In 69% of patients (n=9), azithromycin was associated with resolution of disease, in 15% (n=2) it was ineffective and in 15% (n=2) relapsed was confirmed. Regarding side effects, 3 patients had self-limited digestive symptoms that didn´t lead to discontinuation of therapy.
Conclusion: In this group of patients, macrolide prescription has been shown to be an effective therapy with low associated toxicity. Therefore, this data reinforce the potential use of this drug in patients with OP.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA1410.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019