Prophylactic Antibiotic Use in COPD and the Potential Anti-Inflammatory Activities of Antibiotics

Respiratory Care
Anthony W HuckleIan Todd

Abstract

Antibiotics have previously demonstrated anti-inflammatory properties, and they have been linked to therapeutic benefit in several pulmonary conditions that feature inflammation. Previous research suggests that these anti-inflammatory properties may be beneficial in the treatment of COPD. This review assesses the potential benefit of prophylactic, long-term, and low-dose antibiotic therapy in COPD, and whether any effects seen are anti-inflammatory in nature. Randomized, controlled trials comparing antibiotic therapy with placebo in subjects with stable COPD were evaluated. Twelve trials involving 3,784 participants and a range of antibiotics were included: azithromycin (6 studies, 1,972 participants), clarithromycin (1 study, 67 participants), erythromycin (3 studies, 254 participants), roxithromycin (1 study, 191 participants), and moxifloxacin (2 studies, 1,198 participants). In vitro, in vivo, and ex vivo experimental study designs exploring the mechanisms via which antibiotics may act in subjects with stable COPD were evaluated. Azithromycin and erythromycin showed the greatest effect in subjects with COPD, with evidence suggesting improvement in exacerbation-related outcomes and health status, as measured by the St George...Continue Reading

Citations

Jul 16, 2020·British Journal of Pharmacology·Rachel Yoon Kyung ChangHak-Kim Chan
Jan 16, 2021·The Cochrane Database of Systematic Reviews·Sadia JanjuaSofia Dias
Nov 15, 2020·Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology·Maria Del Mar Mariscal-CazallaMaria Victoria Olmedo-Gaya
Aug 18, 2020·Clinics in Chest Medicine·Nicolas Roche
Oct 31, 2021·Pharmacological Reviews·Jennifer A KrickerMichael J Parnham

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