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Azithromycin asthma

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Azithromycin of no benefit for asthma attacks ● Risk of heart failure with NSAIDs ● Bisphosphonates and steroid-induced osteoporosis ● Triple therapy for moderate-to-severe COPD: marginal benefits ● Much data on adverse events remains unpublished ● Rising placebo response rates in antidepressant trials a 'myth' ● Prenatal fetal RhD testing recommended.
December 1, 2016: Drug and Therapeutics Bulletin
Hamidreza Abtahi, Soheil Peiman, Morteza Foroumandi, Enayat Safavi
Bronchiolitis obliterans (BO) is the most remarkable pulmonary sequels of war-related sulfur mustard inhalation. There is little if any data about long-term efficacy of associated BO treatment. Five years spirometric records of three groups of patients with obstructive pulmonary diseases (asthma, COPD, BO) and documented sulfur mustard inhalation were evaluated. The BO patients were treated with inhaled Seretide 125-250/25 (2 puffs BID), azithromycin (250 mg, three times/week) and N-acetylcysteine (1200-1800/day)...
September 2016: Acta Medica Iranica
Marc Miravitlles, Anthony D'Urzo, Dave Singh, Vladimir Koblizek
Identifying patients at risk of exacerbations and managing them appropriately to reduce this risk represents an important clinical challenge. Numerous treatments have been assessed for the prevention of exacerbations and their efficacy may differ by patient phenotype. Given their centrality in the treatment of COPD, there is strong rationale for maximizing bronchodilation as an initial strategy to reduce exacerbation risk irrespective of patient phenotype. Therefore, in patients assessed as frequent exacerbators (>1 exacerbation/year) we propose initial bronchodilator treatment with a long-acting muscarinic antagonist (LAMA)/ long-acting β2-agonist (LABA)...
September 10, 2016: Respiratory Research
James D Porter, Jennifer Watson, Lee R Roberts, Simren K Gill, Helen Groves, Jaideep Dhariwal, Mark H Almond, Ernie Wong, Ross P Walton, Lyn H Jones, John Tregoning, Iain Kilty, Sebastian L Johnston, Michael R Edwards
BACKGROUND: Exacerbations of asthma and COPD are triggered by rhinoviruses. Uncontrolled inflammatory pathways, pathogenic bacterial burden and impaired antiviral immunity are thought to be important factors in disease severity and duration. Macrolides including azithromycin are often used to treat the above diseases, but exhibit variable levels of efficacy. Inhaled corticosteroids are also readily used in treatment, but may lack specificity. Ideally, new treatment alternatives should suppress unwanted inflammation, but spare beneficial antiviral immunity...
October 2016: Journal of Antimicrobial Chemotherapy
Isamara Simas de Oliveira, Paulo Fernando Tormin Borges Crosara, Geovanni Dantas Cassali, Diego Carlos Dos Reis, Danilo Santana Rodrigues, Flavio Barbosa Nunes, Roberto Eustáquio Santos Guimarães
INTRODUCTION: Macrolides used as immunomodulators are a promising tool for chronic inflammatory airway diseases. Eosinophilic nasal polyposis (ENP) is still considered a disease that is difficult to control with the currently standardized treatments. OBJECTIVES: To evaluate prolonged treatment with low-dose azithromycin for ENP based on clinical and histopathologic variables. METHODS: The present investigation was a self-paired case study of 33 patients with ENP...
January 2016: Allergy & Rhinology
Hengameh H Raissy, Kathryn Blake
The National Asthma Education and Prevention Program's Expert Panel Report 3, Guidelines for the Diagnosis and Management of Asthma does not recommend antibiotics for the management of acute episodes of asthma exacerbation. Macrolides seem to have some potential effect beyond or in addition to their antibacterial effect. It has been reported that macrolides may potentially benefit patients with chronic inflammatory airway diseases due to their antibacterial, antiviral, and/or anti-inflammatory effects. This review presents recent data on use of azithromycin in prevention and management of acute exacerbation of respiratory symptoms in infants and young children...
June 1, 2016: Pediatric Allergy, Immunology, and Pulmonology
Hans Bradshaw, Michael J Mitchell, Christopher J Edwards, Uwe Stolz, Oday Naser, Amanda Peck, Asad E Patanwala
OBJECTIVES: The objective of this study was to determine if physicians would alter their prescribing preferences after sampling liquid formulations of medications for common pediatric diagnoses. METHODS: This was a prospective interventional before/after study conducted at an academic medical center in the United States. The participants of interest included emergency, family medicine, and pediatric physicians. Participants initially completed a brief survey for their primary oral liquid medication of choice for the treatment of selected disease states...
November 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Tinne C J Mertens, Pieter S Hiemstra, Christian Taube
The T helper 2 (Th2) cytokine interleukin(IL)-13 is a central regulator in goblet cell metaplasia and induces the recently described Th2 gene signature consisting of periostin (POSTN), chloride channel regulator 1 (CLCA1) and serpin B2 (SERPINB2) in airway epithelial cells. This Th2 gene signature has been proposed as a biomarker to classify asthma into Th2-high and Th2-low phenotypes. Clinical studies have shown that the macrolide antibiotic azithromycin reduced clinical symptoms in neutrophilic asthma, but not in the classical Th2-mediated asthma despite the ability of azithromycin to reduce IL-13-induced mucus production...
August 2016: Pulmonary Pharmacology & Therapeutics
Narin Sriratanaviriyakul, Celeste Kivler, Tamas J Vidovszky, Ken Y Yoneda, Nicholas J Kenyon, Susan Murin, Samuel Louie
BACKGROUND: Gastroesophageal reflux disease is one of the most common comorbidities in patients with asthma. Gastroesophageal reflux disease can be linked to difficult-to-control asthma. Current management includes gastric acid suppression therapy and surgical antireflux procedures. The LINX® procedure is a novel surgical treatment for patients with gastroesophageal reflux disease refractory to medical therapy. To the best of our knowledge, we report the first case of successful treatment of refractory asthma secondary to gastroesophageal reflux disease using the LINX® procedure...
2016: Journal of Medical Case Reports
Puneet Sahi, Virendra Kumar
No abstract text is available yet for this article.
March 2016: Indian Pediatrics
David Hodgson, John Anderson, Catherine Reynolds, Janet Oborne, Garry Meakin, Helen Bailey, Dominick Shaw, Kevin Mortimer, Tim Harrison
BACKGROUND: Chronic cough is a common clinical problem worldwide. Although many patients have underlying precipitating conditions such as asthma, gastroesophageal reflux, or rhinitis, many remain symptomatic despite treating these conditions. New approaches are needed for the treatment of this group of patients. METHODS: We conducted a randomized, double-blind, placebo-controlled trial to determine whether 250 g of azithromycin three times a week for 8 weeks would affect the Leicester Cough Questionnaire (LCQ) score in 44 patients with treatment-resistant cough...
April 2016: Chest
Ji Young Kang, Mi Ran Jo, Hyeon Hui Kang, Sung Kyoung Kim, Myoung Sook Kim, Yong Hyun Kim, Seok Chan Kim, Soon Seog Kwon, Sook Young Lee, Jin Woo Kim
OBJECTIVES: We investigated the effect of long-term treatment with azithromycin on the pathogenesis of chronic asthma with airway remodeling. METHODS: Six-week-old-BALB/c mice were sensitized with ovalbumin (OVA) combined with lipopolysaccharide (LPS) for 1 month, then challenged with OVA for 3 months. Azithromycin at 75 mg/kg was administered via oral gavage five times a week during the challenge period. Inflammatory cells, T helper 2 cytokines in bronchoalveolar lavage fluid (BAL) fluid, and airway hyperresponsiveness (AHR) were measured...
February 2016: Pulmonary Pharmacology & Therapeutics
Jakob Stokholm, Bo L Chawes, Nadja H Vissing, Elín Bjarnadóttir, Tine M Pedersen, Rebecca K Vinding, Ann-Marie M Schoos, Helene M Wolsk, Sunna Thorsteinsdóttir, Henrik W Hallas, Lambang Arianto, Susanne Schjørring, Karen A Krogfelt, Thea K Fischer, Christian B Pipper, Klaus Bønnelykke, Hans Bisgaard
BACKGROUND: Bacteria and viruses are equally associated with the risk of acute episodes of asthma-like symptoms in young children, suggesting antibiotics as a potential treatment for such episodes. We aimed to assess the effect of azithromycin on the duration of respiratory episodes in young children with recurrent asthma-like symptoms, hypothesising that it reduces the duration of the symptomatic period. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited children aged 1-3 years, who were diagnosed with recurrent asthma-like symptoms from the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort; a birth cohort consisting of the general Danish population of Zealand, including Copenhagen...
January 2016: Lancet Respiratory Medicine
Isamara Simas de Oliveira, Paulo Fernando Tormin Borges Crosara, Geovanni Dantas Cassali, Diego Carlos dos Reis, Camilo Brandão de Resende, Flavio Barbosa Nunes, Roberto Eustáquio Santos Guimarães
INTRODUCTION: The Sino-Nasal Outcome Test 22 (SNOT-22) is an important tool in assessing the quality of life (QoL) of patients with chronic rhinosinusitis with a validated version in Brazil. The eosinophilic nasal polyposis (ENP) represents most of the cases of nasal polyposis (85-90%) and belongs to the group of chronic rhinosinusitis. It is a chronic inflammatory disease that impacts the QoL of patients, not only causing localized symptoms, but also resulting in a general malaise. The standard treatments (corticosteroids and nasal endoscopic surgery) lead to partial control of symptoms, but relapses are frequent...
March 2016: Brazilian Journal of Otorhinolaryngology
Takeshi Shimizu, Harumi Suzaki
In 1984, the effectiveness of low-dose, long-term erythromycin treatment (macrolide therapy) for diffuse panbronchiolitis (DPB) was first reported in Japan. The 5-year survival rate for DPB improved from 62.9 to 91.4% after implementation of macrolide therapy. The usefulness of this treatment has since been demonstrated in patients with other chronic airway diseases, such as chronic bronchitis, cystic fibrosis, bronchiectasis, bronchial asthma, and chronic rhinosinusitis (CRS). The new 14-membered macrolides clarithromycin and roxithromycin and the 15-membered macrolide azithromycin are also effective for treating these inflammatory diseases...
April 2016: Auris, Nasus, Larynx
Guido A Gualdoni, Tilman Lingscheid, Klaus G Schmetterer, Annika Hennig, Peter Steinberger, Gerhard J Zlabinger
Deregulation of inflammasome activation was recently identified to be involved in the pathogenesis of various inflammatory diseases. Although macrolide antibiotics display well described immunomodulatory properties, presumably involved in their clinical effects, their impact on inflammasome activation has not been investigated. We compared the influence of macrolides on cytokine induction in human monocytes. The role of intracellular azithromycin-accumulation was examined by interference with Ca(++)-dependent uptake...
2015: Scientific Reports
Chris S Earl, Teh Wooi Keong, Shi-qi An, Sarah Murdoch, Yvonne McCarthy, Junkal Garmendia, Joseph Ward, J Maxwell Dow, Liang Yang, George A O'Toole, Robert P Ryan
Glucocorticosteroids are used as a main treatment to reduce airway inflammation in people with asthma who suffer from neutrophilic airway inflammation, a condition frequently associated with Haemophilus influenzae colonization. Here we show that glucocorticosteroids have a direct influence on the behavior of H. influenzae that may account for associated difficulties with therapy. Using a mouse model of infection, we show that corticosteroid treatment promotes H. influenzae persistence. Transcriptomic analysis of bacteria either isolated from infected mouse airway or grown in laboratory medium identified a number of genes encoding regulatory factors whose expression responded to the presence of glucocorticosteroids...
May 20, 2015: EMBO Molecular Medicine
Nikita S Goel, Craig N Burkhart, Dean S Morrell
BACKGROUND: Periorificial dermatitis (POD) is a rosacea-like papulopustular facial eruption most commonly reported in young adult women. Although POD has been reported in children as young as 6 months of age, there are limited data on the diagnosis and management of POD in pediatric cases. METHODS: All children diagnosed with POD at the Dermatology Clinic at the University of North Carolina at Chapel Hill between June 2002 and March 2014 were included in the current study...
May 2015: Pediatric Dermatology
Hiroaki Baba, Yoshitake Sato, Yoshikiyo Toyonaga, Hideaki Hanaki, Keisuke Sunakawa
Based on the results of surveillance in the pediatric field conducted in 2007, 2010, and 2012, we examined the frequency of Haemophilus influenzae serotype b (Hib) strains, the susceptibility for Hib strains to various types of antimicrobial agent, and the relations to patients' background factors. Among all of Haemophilus influenzae, the frequency of Hib strains was 3.6% (14/386 strains) in 2007, 4.8% (23/484 strains) in 2010, 1.2% (5/411 strains) in 2012, and decreasing in 2012. Hib strains were isolated in patients with the following infections: nine patients with respiratory tract infections (upper respiratory tract infection, bronchitis, and pneumonia), three patients with sepsis, one patient with meningitis, and one patient with purulent inflammation of a tendon sheath in 2007; 11 patients with respiratory tract infections (upper respiratory tract infection, bronchitis, and pneumonia), four patients with sepsis, and eight patients with meningitis in 2010, demonstrating a relatively high frequency in patients with invasive infections...
April 2015: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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