The Effect of Erythromycin on Mucociliary Transportability and Rheology of Cystic Fibrosis and Bronchiectasis Sputum

Abstract

Background: Erythromycin has been shown to diminish sputum production in hypersecretory states by a mechanism that is still unclear. Objectives and Methods: We have investigated the effect of erythromycin on the ciliary transportability of cystic fibrosis and non-cystic fibrosis bronchiectasis sputum in vitro using the mucus-depleted bovine trachea. Results: Additional erythromycin in concentrations up to 20 µg/g did not significantly alter the ciliary transportability of sputum from 6 cystic fibrosis and 6 bronchiectasis patients. Sputum viscoelasticity measured with parallel-plate rheology was also little changed. These erythromycin concentrations also had little effect on the beating frequency of bovine tracheal cilia. Conclusions: These results suggest that the presence of erythromycin in sputum neither alters the physical properties of the gel nor the activity of cilia. The clinical effects of erythromycin on pulmonary hypersecretory states therefore have another explanation.