Effectiveness of long-term treatment with erythromycin in patients with Asthma-COPD overlap syndrome

Abstract

The low dose of macrolide antibiotics have been shown to improve the lung function and reduce frequency of infective exacerbations in COPD patient. Several reports showed the effectiveness of azithromycin in some patients with asthma. However, little is known about the potential for macrolide therapy to translate these effects to patients with ACOS. Objective: To study the effectiveness of low-dose and long-term treatment with erythromycin in ACOS patients. Methods: Our study involved 64 ACOS patients divided into erythromycin (45 patients) and a control group – 19 patients (without erythromycin treatment). The erythromycin group was subdivided into group A – 20 patients (treated with 400 mg of oral erythromycin daily for 12 months) and group B – 25 patients (treated with 400 mg of oral erythromycin for 6 months). Inflammatory cells in induced sputum, pulmonary function, and the 6-minute walk distance (6MWD) were analyzed. Results: After treatment, sputum significantly decreased in groups A and B compared with control group. Treatment with erythromycin decreased the total cell counts in group A more than in group B (p Conclusions: Erythromycin reduced airway inflammation, total number of cells, neutrophil counts, and neutrophil ratio in induced sputum in ACOS patients. Macrolide therapy was associated with a significant reduction in exacerbations. Patients treated with erythromycin for 6 months experienced improved exercise capacity. Treatment for 12 months may be more effective than treatment for 6 months.