Effects of claritromycin on inflammatory parameters and clinical conditions in children with bronchiectasis1

Authors

  • E. Yalçın MD,

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • N. Kiper MD,

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • U. Özçelik MD,

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • D. Doǧru MD,

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • P. Fırat MD,

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • A. Şahin MD,

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • M. Arıyürek MD,

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • G. Mocan MD,

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • N. Gürcan Chemist,

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • A. Göçmen MD

    1. *Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey , †Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey , ‡Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey and §Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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  • 1

    This study was presented in the 24th European CF Conference (Vienna, Austria 6–9 June 2001).

Ebru Yalçın, Chest Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100-Ankara/Turkey. Tel.: (+90) 312 305 1334; fax: (+90) 312 324 3284; e-mail: ebruy@hacettepe.edu.tr

Summary

Background:  The effects of the macrolides cannot be ascribed to their antibacterial action alone. Their immunoregulatory and anti-inflammatory functions are significant too. They are frequently used in the treatment of diffuse panbronchiolitis and cystic fibrosis (CF).

Aim:  To evaluate the effects of a macrolide antibiotic [clarithromycin (CAM)] on the process of inflammation [by measuring IL-8, TNF-α, IL-10 levels and cell profiles in bronchoalveolar lavage (BAL) fluid], pulmonary function and sputum production in children with steady-state bronchiectasis, secondary to causes other than CF or primary immunodeficiencies.

Methods:  Seventeen patients randomized to the treatment group received CAM and supportive therapies for 3 months and 17 patients in the control group were given supportive therapies only.

Results:  Compared with the control group, the treatment group showed a significant decrease in IL-8 levels, total cell count, neutrophil ratios in BAL fluid and daily sputum production at the end of the third month. There was also a significant increase in the treatment group's BAL fluid macrophage ratios. The differences in pulmonary function test parameters were not significant.

Conclusion:  Use of CAM in children with steady-state bronchiectasis results in laboratory improvement by reducing the inflammatory processes in the lungs. No corresponding clinical improvement could be shown but although this is possible with long-term use, trial validation is necessary.

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