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Do the macrolides have a role in the treatment of cystic fibrosis?
There is growing interest in the potential use of macrolide antibiotics as anti-inflammatory agents in cystic fibrosis. This stems from the dramatic success of long term erythromycin in the treatment of diffuse panbronchiolitis (DPB), a condition with a high prevalence in Japan but rare elsewhere.1–3 Clinically, DPB exhibits some similarities to cystic fibrosis including chronic productive cough, exertional dyspnoea, chronic sinusitis, mucoid Pseudomonas aeruginosa colonisation, and bronchiectasis. The introduction of erythromycin as a treatment for DPB has had a dramatic impact on mortality, increasing 10 year survival from 12.4–21.9% to over 90% in those colonised with P aeruginosa.3,4 Similar success has been reported with clarithromycin, roxithromycin, and azithromycin.1,3 While the aetiology of both conditions may be very different, it is the similarities which beg the question “do the macrolides have a role in the treatment of cystic fibrosis?”
The macrolide antibiotics are an intriguing group of drugs with both anti-inflammatory and antibacterial …
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