Azithromycin therapy in children with postinfectious bronchiolitis obliterans

Abstract

Introduction: Macrolide antibiotics maybe effective in the treatment of post transplant bronchiolitis obliterans (BO) due to their antiinflammatory and immunomodulatory properties. Aim: We aimed to evaluate the effectiveness of azithromycin therapy in children with postinfectious BO (PIBO). Methods: The medical files of the PIBO patients followed at three different centres were retrospectively evaluated. Pulmonary function tests (PFT), physical examination findings and symptoms of patients were recorded at 2nd, 4th, 6th, 9th and 12th months. Impulse oscillometry (IOS) results of all patients and spirometry results of 13 patients (who could cooperate with the procedure) were obtained. Results: The medical files of 19 PIBO patients (mean age:109±59 months, 21% female) were evaulated. Eight patients received azithromycin for six months. Those eight patients were compared to 11 patients who did not receive azithromycin. There was no difference between the two groups in terms of age, gender, z-score of weight, symptoms and PFT. When the IOS and spirometry results were compared, there was a significant difference only in terms of R20 and X20 results at the second month (p=0.012 and 0.012) and R15% and R20% and FEV1 results (p=0.033, 0.033 and 0.042) at the forth month in the azithromycin group. Conclusion: Although the small number of patients is a limitation, there was no difference in the PFT results of the PIBO patients who received azithromycin at the end of six months.