Abstract
Introduction: During the past three decades there has been increasing interest in the anti-inflammatory effects of macrolides.
Objective: To review current data about anti-inflammatory mechanisms of these drugs, and to examine their effect on modulation of the inflammatory pathways, neutrophil function, bronchoconstriction, and Pseudomonas biofilm.
Methods: A systematic review considering original papers and review articles at the National Library of Medicine (MEDLINE/Pubmed), using as key words macrolides, azithromycin, clarithromycin, immunomodulating, antiinflammatory, airway, cystic fibrosis, asthma, sinusitis and children, were performed.
Results: Low-dose macrolide therapy has dramatically increased survival in patients with diffuse panbronchiolitis. This has led to further investigation into the potential use of macrolides in chronic lung diseases with an inflammatory component such asthma, cystic fibrosis and bronchiectasis. However, the current evidence to guide this approach, should be considered as only recommendations.
Conclusion: The anti-inflammatory effects of these drugs have been under extensive investigation, but randomized and controlled clinical trials in children with respiratory condition are just beginning. The benefits and potential side effects need to be determined before routine use can be advised.
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