Azithromycin in chronic respiratory infections with pseudomonas aeruginosa in patients without cystic fibrosis
M. Zlatev Ionescu, O. Nicolaescu, M. Nica, A. M. Petrescu, C. Calomfirescu, E. Ceausu, P. I. Calistru (Bucarest, Romania)
Source: Annual Congress 2008 - Mechanisms of respiratory infections: interaction between the pathogen and the host
Disease area: Respiratory infections
Abstract Objectives : patients without cystic fibrosis, with chronic respiratory infections with Pseudomonas aeruginosa (PA), have a decreased quality of life, frequent exacerbations and hospitalizations. Azithromycin treatment can be used to try to prolong the exacerbation free period. Methods : prospective study on 25 patients with bronchiectasis with more than 3 hospitalizations/year for exacerbations, admitted to the pulmonary diseases ward between 2004-2006, who received azithromycin 250- 500 mg/every other day for 6 months, evaluated initially, at T3, T6, and T9 months. Results : 24/25 completed the study; median age: 62, 29 yrs; St George Respiratory Questionnaire on the Quality of Life: the Impact and Symptoms Domains where ameliorated at 3 and 6 months (p≤ 0, 5); Respiratory functions FEV1 -43% median value, maintained its values during the treatment and decreased significantly at T9;12/25 had chronic respiratory insufficiency. Bacteriology: 41 % mucous phenotype, 10 different lisotypes; CFU/ml decreased significantly at T6. Chimiosensitivity pattern changed during the treatment including restoration of sensitivity to ciprofloxacin and ceftazidime (2/24 patients). Azithromycin reduces the synthesis of pyocyanin and pioverdin at concentrations of 8, 5 and 2 mg/dl. in the mucous phenotype of PA. The number of admissions and days of admission (p< 0, 5) decreased during the treatment.Conclusions: azithromycin alleviates symptoms and decreases the number of exacerbations during the treatment, but these tend to reoccur after 3 months of the interruption of treatment.
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M. Zlatev Ionescu, O. Nicolaescu, M. Nica, A. M. Petrescu, C. Calomfirescu, E. Ceausu, P. I. Calistru (Bucarest, Romania). Azithromycin in chronic respiratory infections with pseudomonas aeruginosa in patients without cystic fibrosis. Eur Respir J 2008; 32: Suppl. 52, 2290
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