Long-term survival after lung transplantation is limited by the development of bronchiolitis obliterans syndrome (BOS). Recently, a pilot study reported an improvement in lung function in 5 of 6 lung transplant recipients with BOS treated with oral azithromycin. However, there are no available data on the long-term effect of macrolides in BOS.
The study sample consisted of 11 lung transplant recipients with BOS who were treated with oral azthromycin 250 mg three times per week for a mean duration of 10 months. Spirometry was performed at each follow-up visit (every 4 weeks) to evaluate forced expiratory volume in 1 sec (FEV1). Follow-up began with onset of treatment and continued to the time of article preparation.
Mean FEV1 measured 40±9% at initiation of azithromycin treatment, 39±10% after one month, and 39±12%, 38±10%, and 38±10% after 4, 7, and 10 months, respectively (p=NS for all data). FEV1 improved after 4 months in 2 patients, although both returned to their basal lung function on long-term follow-up. No significant decline in lung function was noted in the 2 patients with gastroesophageal reflux disease compared to the other patients, or in the 9 patients with Pseudomonas colonization.
Findings of the present open pilot study indicate that long-term azithromycin therapy has no effect in lung transplant recipients with BOS.
Long-term Azithromycin Therapy may be assumed to play no Effective Role in Lung Transplant Recipients.
D. Shitrit, None.