Macrolide antibiotic may reduce COPD exacerbations after long-term usage

The long-term usage of a macrolide antibiotic might reduce the frequency of exacerbations by as much as 35 percent in patients with moderate to severe chronic obstructive pulmonary disease, according to a London-based study.

As per lead author of the paper, Terence A. R. Seemungal, Ph.D., and Jadwiga Wedzicha, M.D., principle investigator, attained results display a significant effect of low-dose macrolide therapy reducing the exacerbation frequency and severity with moderate to severe COPD.

From News-Medical.Net:

While their findings are encouraging, Dr. Seemungal points out that they must be put in context with future findings. Furthermore, the threat of growing antibiotic resistance resulting from widespread prophylactic use of erythromycin is not a trivial concern. “In this scenario, substantial, widespread emergence of macrolide bacterial resistance is virtually foreordained, with attendant reduction in the antimicrobial usefulness of this drug class,” wrote Ken M. Kunisaki, M.D. and Denise E. Niewoehner, M.D., of the Veterans Affairs Medical Center in Minneapolis, in the accompanying editorial. “Balancing benefit against harm could pose a dilemma for which there might be no clear answers.”

Moreover, not all of the study patients were treated with guideline-recommended therapy, such as inhaled corticosteroids or inhaled long-acting bronchodilators, which have been shown to decrease exacerbation frequency. The degree of added benefit of erythromycin over and above standard therapy will require further study.

“Observations that any intervention might decrease the frequency and severity of acute exacerbations in COPD present considerable public health implications,” observed John Heffner, M.D., past president of the ATS. “Exacerbations occur about once a year among patients with moderate to severe COPD and account for more than $30 billion dollars in direct and indirect costs annually in the United States alone.”

This recently concluded study is considered as the first ever year-long randomized and placebo-controlled study of erythromycin’s effects in COPD. The study results were published in the first issue for December of the American Journal of Respiratory and Critical Care Medicine that is published by the American Thoracic Society.

Tags: chronic obstructive pulmonary disease, COPD, corticosteroids, erythromycin, macrolide antibiotic, macrolide therapy

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