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Editorials |

Macrolides for Acute Lung InjuryMacrolides for Acute Lung Injury

Michael J. Noto, MD, PhD; Arthur P. Wheeler, MD, FCCP
Author and Funding Information

From the Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University.

Correspondence to: Arthur P. Wheeler, MD, FCCP, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University, T-1210 MCN, Nashville, TN 37232-2650; e-mail: art.wheeler@vanderbilt.edu


Funding/Support: The authors are supported by the National Institutes of Health [Grant 5T32HL094296-04].

Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(5):1131-1132. doi:10.1378/chest.11-3245
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In this issue of CHEST (see page 1153), Walkey and Wiener1 examine the association between receipt of a macrolide antibiotic and mortality in patients with acute lung injury (ALI). The authors used existing, publicly available data from the Acute Respiratory Distress Network (ARDSNet) Lisofylline and Respiratory Management of Acute Lung Injury (LARMA) trial in which 235 patients were randomized in a two-by-two fashion to receive low tidal volume vs standard tidal volume ventilation and either lisofylline or placebo.2 The exposure of interest in this study was receipt of a macrolide antibiotic within 24 h of enrollment (47 of 235 patients studied received a macrolide). After adjustment for confounding variables, patients who received a macrolide antibiotic had a significant reduction in mortality and shorter time to discontinuation of mechanical ventilation. By contrast, patients who received a fluoroquinolone or cephalosporin, compared with patients who did not, had no survival advantage, suggesting that this benefit was due to macrolides.

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