Clarithromycinin for Acute Exacerbation of Recurrent Wheezing in Children
Clarithromycinin for Acute Exacerbation of Recurrent Wheezing in Children
Fonseca-Aten M, Okada PJ, Bowlware KL, et al.
Ann Allergy Asthma Immunol. 2006;97:457-463
For a number of years, there have been reports describing the use of macrolide antibiotics to treat patients with asthma. Some have postulated that this class of antibiotics possesses anti-inflammatory or immunomodulatory properties that would benefit patients with asthma. Others have argued that at least some patients with asthma may have a chronic infection with either a Chlamydia or Mycoplasma species which is contributing to their asthma symptomatology, and therefore the antibiotic is beneficial because of antimicrobial rather than anti-inflammatory action. Still others have suggested that it may be combination of these actions.
Fonseca-Aten and coworkers investigated whether or not a 5-day course of clarithromycin (weight-adjusted up to a maximum dose of 500 mg twice daily for 5 days) would alter nasopharyngeal or serum inflammatory cytokines in children with a history of recurrent wheezing who received either the drug or placebo within 3 days of the onset of an episode of acute wheezing. They found that nasopharyngeal concentrations of tumor necrosis factor alpha [TNF-a] and interleukins 1-beta [IL-1b] and interleukin 10 [IL-10] were significantly and persistently lower in children who had been treated with clarithromycin compared with those who were treated with placebo. Of interest, there seemed to be a greater effect on suppression of nasopharyngeal inflammatory mediators in those who had a positive polymerase chain reaction (PCR) to either Mycoplasma pneunmoniae or Chlamydophila pneumoniae compared to those without evidence of infection to those organisms.
This article continues to strengthen the association between Mycoplasma pneunmoniae or Chlamydophila pneumoniae and asthma. There are some who believe that the link will become strong enough to parallel the relationship between peptic ulcer disease and Helicobacter pylori. We will continue to watch as the evidence mounts regarding the benefit of macrolide antibiotic therapy in patients with asthma.
Abstract
Fonseca-Aten M, Okada PJ, Bowlware KL, et al.
Ann Allergy Asthma Immunol. 2006;97:457-463
For a number of years, there have been reports describing the use of macrolide antibiotics to treat patients with asthma. Some have postulated that this class of antibiotics possesses anti-inflammatory or immunomodulatory properties that would benefit patients with asthma. Others have argued that at least some patients with asthma may have a chronic infection with either a Chlamydia or Mycoplasma species which is contributing to their asthma symptomatology, and therefore the antibiotic is beneficial because of antimicrobial rather than anti-inflammatory action. Still others have suggested that it may be combination of these actions.
Fonseca-Aten and coworkers investigated whether or not a 5-day course of clarithromycin (weight-adjusted up to a maximum dose of 500 mg twice daily for 5 days) would alter nasopharyngeal or serum inflammatory cytokines in children with a history of recurrent wheezing who received either the drug or placebo within 3 days of the onset of an episode of acute wheezing. They found that nasopharyngeal concentrations of tumor necrosis factor alpha [TNF-a] and interleukins 1-beta [IL-1b] and interleukin 10 [IL-10] were significantly and persistently lower in children who had been treated with clarithromycin compared with those who were treated with placebo. Of interest, there seemed to be a greater effect on suppression of nasopharyngeal inflammatory mediators in those who had a positive polymerase chain reaction (PCR) to either Mycoplasma pneunmoniae or Chlamydophila pneumoniae compared to those without evidence of infection to those organisms.
This article continues to strengthen the association between Mycoplasma pneunmoniae or Chlamydophila pneumoniae and asthma. There are some who believe that the link will become strong enough to parallel the relationship between peptic ulcer disease and Helicobacter pylori. We will continue to watch as the evidence mounts regarding the benefit of macrolide antibiotic therapy in patients with asthma.
Abstract