Role for macrolides
- Fonseca-Aten M.
- Okada P.J.
- Bowlware K.L.
- Chavez-Bueno S.
- Mejias A.
- Rios A.M.
- et al.
Role for nebulised antibiotics
|Study (Reference)||Study design||Number of subjects||Duration of study||Antibiotic||Outcomes|
|Amayasu et al.|
|Randomised DBPC Crossover study||17 adult subjects with mild-to-moderate atopic asthma||8 weeks||CRM|
|Black et al.|
|Randomised DBPC||219 asthmatic subjects with serological evidence of C. pneumoniae infection as demonstrated by IgG and IgA antibody titres||6 weeks||RXM|
|Kamada et al.|
|Randomised DBPC Gp A: TDM + MP; Gp B: TDM + prednisolone; Gp C: placebo + MP||19 children (6–17 yrs) with OCS-dependent asthma (OCS tapering study)||12 weeks||TDM|
|Kostadima et al.|
|Randomised DBPC of Gp A: CRM b.i.d.; Gp B: CRM t.i.d.; Gp C: placebo||75 adult subjects with mild persistent asthma||8 weeks||CRM|
|Kraft et al.|
|Randomised DBPC||55 adult subjects with moderate persistent asthma (31 with evidence of C. pneumoniae or M. pneumoniae infection)||6 weeks||CRM|
|Nelson et al.|
|Randomised DBPC of TDM + MP vs. placebo + MP||75 adult asthmatic subjects with severe persistent asthma (OCS tapering study)||52 weeks (single blind for 52 weeks for 57 subjects [TDM n = 30; Placebo n = 27]||TDM|
|Shoji et al.|
|Randomised DBPC Crossover study||14 adult subjects with aspirin-intolerant mild/moderate asthma||8 weeks||RXM|
Chronic Obstructive Pulmonary Disease (COPD)
- Gomez J.
- Banos V.
- Simarro E.
- Lorenzo Cruz M.
- Ruiz Gomez J.
- Latour J.
- et al.
- Seemungal T.A.
- Wilkinson T.M.
- Hurst J.R.
- Perera W.R.
- Sapsford R.J.
- Wedzicha J.A.
- Seemungal T.A.
- Wilkinson T.M.
- Hurst J.R.
- Perera W.R.
- Sapsford R.J.
- Wedzicha J.A.
|Study||Study design||Number of subjects||Duration of study||Antibiotic||Outcomes|
|Albert et al.|
|Randomised placebo control study||1577||12 months||Azithromycin250 mg daily|
|He et al.|
|Randomised DPBC trial||36||6 months||Erythromycin125 mg three times daily|
|Blasi et al.|
|Randomised uncontrolled trial||22||6 months||Azithromycin 500 mg three times a week|
|Seemungal et al.|
Long-term erythromycin therapy is associated with decreased chronic obstructive pulmonary disease exacerbations.
Am J Respir Crit Care Med. 2008 Dec 1; 178 ([Randomized Controlled Trial Research Support, Non-U.S. Gov't]): 1139-1147
|Randomised DPBC trial||109||12 months||Erythromycin250 mg twice daily|
|Banerjee et al.|
|Prospective Randomised DPBC trial||67||3 months||Clarithromycin 500 mg once daily|
|Sethi et al.|
|Randomised DPBC trial||1157||48 months||6 courses of Moxifloxacin 400 mg OD for 5 days|
Cystic fibrosis (CF)
|Study||Study design||Number of subjects||Duration|
|Saiman et al.|
|Randomised Placebo controlled||185(87 treatment group)||6 months||Azithromycin||Improved FEV1, reduced number of exacerbations,|
|Wolter et al.|
|Randomised placebo controlled||60 adult CF patients||3 months||Azithromycin||No decline in FEV1, fewer courses of IV antibiotics, decline in C reactive protein, improvement in QOL|
|Kabra et al.|
|Randomised controlled||56 children||12 months||Azithromycin low dose 5 mg/kg/day compared with high dose 15 mg/kg/day||No difference in clinical score, FEV1 and pulmonary exacerbation rates between the two groups|
|Hodson et al.|
|Randomised controlled||115||4 weeks||Nebulised colomycin compared with nebulised tobramycin||Both treatments reduced bacterial load. Nebulised tobramycin improved lung function in CF patients chronically colonised with P. aeruginosa|
|Ramsey et al.|
|Randomised placebo controlled||520||24 weeks||Nebulised tobramycin||Improvement in pulmonary function, decrease in the density of P. aeruginosa in sputum, decreased risk of hospitalization|
|McCoy et al.|
|Randomised controlled||211||28 days||Inhaled aztreonam solution||Improvement in pulmonary function and respiratory symptoms|
|Retsch-Bogart et al.|
|Randomised placebo controlled||164||28 days||Inhaled aztreonam solution||Improvement in pulmonary function and respiratory symptoms|
|Oermann et al.|
|Open label||274||18 moths||Inhaled aztreonam solution||Clinical benefits in pulmonary function, health-related quality of life, and weight|
|Ledson et al.|
|Randomised double blinded cross over||20||4 weeks||Inhaled taurolidine||No change in B. cepacia colony count or spirometry, nor symptom score|
|Frederiksen et al.|
|Comparison with historical control||48 patients compared with 43 control||44 moths||Inhalation of colistin and oral ciprofloxacin||16% of the treated patients developed chronic P. aeruginosa infection compared with 72% of the control patients (P < 0.005), improvement in lung function|
|Gibson et al.|
|Randomised double blind||21||28 days||Inhaled tobramycin||Reduction in P. aeruginosa density|
|Geller et al.|
|Randomised placebo controlled||151||28 days||Inhaled ciprofloxacin||Reduction in P. aeruginosa density, improvement in pulmonary function (FEV1), reduction in need for anti-pseudomonal antibiotics|
- Bilton D.
- Serisier D.J.
- De Soyza A.T.
- Wolfe R.
- Bruinenberg P.
- Barker A.F.
- Couch L.
- Fiel S.B.
- Gotfried M.H.
- Ilowite J.
- Meyer K.C.
- et al.
|Study||Study design||Number of subjects||Duration of study||Antibiotic||Outcomes|
|Murray et al.|
|Randomised placebo controlled trial||65||12 months||Neb gentamicin 80 mg twice daily|
|Orriols et al.|
|Open labelled study||17||12 months||Neb ceftazidime 1 gm bd & Neb tobramycin 100 mg bd or placebo|
|Drobnic et al.|
|Double blind placebo controlled crossover trial||30||6 months||Nebulised tobramycin 300 mg twice daily|
|Yalcin et al.|
|Randomised placebo controlled||34 (children)||3 months||Clarithromycin 15 mg/kg|
|Davies et al.|
|Prospective open labelled||39||10 months||Azithromycin 250 mg three times weekly|
|Currie et al.|
|Randomised placebo controlled||38||32 weeks||Amoxicillin 39 twice daily|
- Bilton D.
- Serisier D.J.
- De Soyza A.T.
- Wolfe R.
- Bruinenberg P.
Diffuse panbronchiolitis (DPB)
|Study||Study design||Number of subjects||Duration of study||Antibiotic used||Outcomes|
|Akira et al.|
|Observational RCT of efficacy of macrolide treatment||19 subjects (12 active treatment and 7 no treatment)||Not specified||Erythromycin|
|Kudoh et al.|
|Retrospective observational survival study based on year of diagnosis||498 subjects(Gp A: 1970–79 [only std ABx avail} [n = 190]; Gp B: 1980–84 [quinolones avail][n = 221]; Gp C: 1985–90 (Erythromycin avail} [n = 87])||N/A||Erythromycin|
|Yamamoto et al.|
|Retrospective observational study comparing quinolone vs. macrolide||101 subjects||N/A||Erythromycin|
|Kobayashi et al.|
|Open-labelled study of efficacy and safety||60 subjects (efficacy data on 52 and safety data on 55)||12 weeks||Azithromycin|
|Kadota et al.|
|Prospective open-labelled study||10 subjects||4 years||Clarithromycin|
Post-transplant bronchiolitis obliterans syndrome (BOS)
Opinions and conclusions
Conflict of interest statement
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