Chronic infections such as Mycoplasma pneumoniae and Chlamydia pneumoniae can maintain inflammatory response in chronic asthma. Macrolide antibiotics have both antimicrobial and anti-inflammatory effects that can potentially alter the course of inflammation in chronic asthma.
Thirty patients with chronic and stable asthma were recruited from outpatient clinic of Cerrahpaşa Medical Faculty. The study was randomized, double-blinded, placebo-controlled, and in crossover design. IgM and IgG antibodies to Chlamydia pneumoniae and Mycoplasma pneumoniae, markers of eosinophilic inflammation, and spirometric measurements were done initially, before crossover, and after crossover. Patients were given clarithromycin 500 mg bid or placebo for 6 weeks. Before crossover period there was 2 weeks given for washout period.
Twenty-five females and 5 males with mean 35 years of age were analyzed. The mean duration of the disease was 5.8 years. Initial workup of lung functions, IgM and IgG antibodies to Chlamydia pneumoniae and Mycoplasma pneumoniae, markers of eosinophilic inflammation were similar in both groups. Treatment did not influenced FEV1 (2730±675ml, 2610±792ml, and 2680±895ml, 2630±992ml, p>0.05) before or after crossover. There were no significant differences in eosinophil counts or antibodies in those subjects who received placebo.CONCLUSIONS: The role of clarithromycin in the treatment of asthma in suppression of the inflammatory response to either chronic infections or allergic phenomena seemed not to be efficacious in our study.
Considering the small number of patients and the short duration of study, it is not likely to conclude refuting the use of macrolides in patients with chronic asthma.
I.F. Talasli, None.