Roxithromycin as Anti-Inflammatory Drug Improves Clinical Outcomes in Adult Patients with Bronchiectasis: A Double- Blinded Randomized, Placebo-Controlled Pilot Clinical Trial

Abstract

Objective: Macrolides are anti-inflammatory agents that have been reported to improve symptoms in bronchiectasis. The objectives of this study were roxithromycin 300 milligrams (mg) once daily for 8 weeks in patients with bronchiectasis improves the symptom scores as the primary outcome, and the pulmonary function tests and quality of life as the secondary outcomes.Material and Methods: This was a randomized double-blinded placebo-controlled trial of roxithromycin or placebo once daily for 8 weeks in patients with bronchiectasis. Symptom scores, pulmonary function tests, St. George’s Respiratory Questionnaire (SGRQ), and sputum culture were done at each visit.Results: Twenty-eight bronchiectasis patients with a mean age of 56 years participated in this study. Fourteen patients were randomized to receive either roxithromycin 300 mg or placebo once daily. Roxithromycin was shown to improve symptom scores (mean difference of symptom scores=–1.66, p-value=0.005) compared with placebo (mean difference of symptom scores=-0.06, p-value=0.94). Quality of life assessed by the SGRQ, significantly improved in the roxithromycin group (p-value=0.012) but not in the placebo group (p-value=0.84). Pulmonary function tests (forced expiratory volume in one second, forced vital capacity, and diffusing lung capacity of the lung for carbon monoxide) did not improve in either group. None of the patients in the roxithromycin group reported any adverse effects.Conclusion: Roxithromycin once daily showed benefits in clinical outcomes such as symptoms and quality of life. Larger studies of the effects of roxithromycin in bronchiectasis with longer follow-up should be done.