The Turkish Journal of Pediatrics
2009 , Vol 51 , Num 5
Long-Term Clarithromycin in Cystic Fibrosis: Effects on Inflammatory Markers in BAL and Clinical Status
1Pediatric Pulmonary Medicine Unit, Department of Pediatrics, and Departments of 2Anesthesiology and Reanimation,
and 4Pathology, and 3Clinical Microbiology Laboratory, Hacettepe University Faculty of Medicine, Ankara, Turkey
Macrolides have antiinflammatory effects that are potentially useful in cystic
fibrosis (CF). In this placebo-controlled, randomized, double-blind crossover
study, 18 CF patients were randomized to receive either clarithromycin
(CM) (Group 1) or placebo (Group 2) for three months. After 15 days, the
treatments were crossed over. Bronchoalveolar lavage (BAL) was obtained
in the beginning and at the end of each treatment period. There was no
significant difference in median cell counts and median cytokine levels at
baseline, after CM use and after placebo use between the two groups. In
Group 2, the median neutrophil elastase (NE) level decreased with CM.
Patients had less acute pulmonary exacerbations and median clinical score
decreased with CM in both groups. Median z-scores for weight increased
with CM in Group 2. We could not demonstrate a fall in proinflammatory
cytokines in BAL; however, some improvement in clinical status could be
shown with three-month CM.
Keywords :
clarithromycin, cystic fibrosis, clinical status, inflammation