RT Journal Article
SR Electronic
T1 Azithromycin for cystic fibrosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 834
OP 838
DO 10.1183/09031936.04.00084304
VO 24
IS 5
A1 K.W. Southern
A1 P.M. Barker
YR 2004
UL http://erj.ersjournals.com/content/24/5/834.abstract
AB During what is a relatively barren time for new therapies for cystic fibrosis (CF), azithromycin has received a lot of attention as a potential treatment for CF lung disease. Laboratory studies suggest that azithromycin may have indirect actions, including anti-inflammatory, in addition to the standard antibacterial properties. The unique pharmacokinetics of azithromycin sets it aside from other macrolide antibiotics, but may result in increased resistance patterns. Three well-designed randomised controlled trials have demonstrated a small but significant improvement in respiratory function (forced expiratory volume in one second) with azithromycin compared with placebo. These trial results are confirmed by a recent meta-analysis. Mild adverse events (wheeze, diarrhoea and nausea) were significantly increased in one trial. There is no clear consensus regarding the correct dose and length of treatment with azithromycin. The present review discusses the role of azithromycin in the management of cystic fibrosis and the need for close monitoring of patients started on this drug. In addition, clinics should liaise closely with their microbiology departments and monitor resistance patterns. P.M. Barker has been co-investigator on a study examining clarithromycin for cystic fibrosis, which received grant support from Abbott Laboratories.