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Low-dose, long-term macrolide therapy in asthma: An overview

Umur Hatipoğlu and Israel Rubinstein*

Author Affiliations

Section of Respiratory and Critical Care Medicine, Department of Medicine and Department of Biopharmaceutical Sciences, Colleges of Medicine and Pharmacy, University of Illinois at Chicago, and VA Chicago Health Care System, Chicago, Illinois 60612, U.S.A

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Clinical and Molecular Allergy 2004, 2:4  doi:10.1186/1476-7961-2-4

Published: 16 March 2004


Macrolides, a class of antimicrobials isolated from Streptomycetes more than 50 years ago, are used extensively to treat sinopulmonary infections in humans. In addition, a growing body of experimental and clinical evidence indicates that long-term (years), low (sub-antimicrobial)-dose 14- and 15-membered ring macrolide antibiotics, such as erythromycin, clarithromycin, roxithromycin and azithromycin, express immunomodulatory and tissue reparative effects that are distinct from their anti-infective properties. These salutary effects are operative in various lung disorders, including diffuse panbronchiolitis, cystic fibrosis, persistent chronic rhinosinusitis, nasal polyposis, bronchiectasis, asthma and cryptogenic organizing pneumonia.

The purpose of this overview is to outline the immunomodulatory effects of macrolide antibiotics in patients with asthma.

Inflammation; cytokines; antibiotics