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
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