Long-term administration of macrolide antibiotics decreases excessive amounts of sputum in patients with chronic airway diseases having airway hypersecretion. This effect may not be attributed to their antimicrobial activities but rather to anti- inflammatory and/or anti-secretory actions. For example, 14-membered macrolides including erythromycin, clarithromycin and roxithromycin potently attenuate mucus glycoprotein secretion from airway submucosal glands and goblet cells, and inhibit airway epithelial Cl secretion and, hence, water movement toward the airway lumen. In addition, we have recently shown that 7-day treatment with clarithromycin decreased daily sputum production, whereas amoxicillin or cefaclor did not in patients with chronic bronchitis and bronchiectasis. This anti-secretory effect was accompanied by the increase in solid composition and the decrease in Cl concentration in the sputum, indicating that a short-course therapy with macrolide is also effective in airway hypersecretion.
Buy this Article