According to a recent review published in the European Journal of Clinical Microbiology & Infectious Diseases, azithromycin is an effective drug for patients with Cystic Fibrosis suffering from P. aeruginosa infections. The researchers observed efficacy during its first year of administration, however, the impact of longer treatment is debated.
In their review titled “Azithromycin use in patients with cystic fibrosis,” researchers at Università deli Studi di Milano in Italy, led by Susanna Esposito from the Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, noted that currently, rational antimicrobial administration is still considered to be the most effective therapeutic approach in cystic fibrosis (CF). Long-term treatment with azithromycin (Az) is included in the most recent guidelines for CF patients that are age below 6 years old.
Azithromycin has microbiological, immunomodulatory and anti-inflammatory characteristics that may help reduce particular biological problems that are implicated in the etiology of the progressive lung damage that is associated with cystic fibrosis.
In their review, Susanna Espostio and colleagues argued that although azithromycin is known to be ineffective against Pseudomonas aeruginosa, which is the most relevant and harmful pathogen known to cause CF exacerbations, the drug has been found effective against P. aeruginosa infections. This is mainly because azithromycin in sub-inhibitory concentrations has been found to diminish P. aeruginosa infections by increasing their defenselessness to other antibiotics. The authors also note that recent studies have demonstrated that Azithromycin has an anti-viral activity capable of reducing the risk of exacerbations that occur after mild viral infections.
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In the review, the researchers concluded that available evidence from studies indicate that Azithromycin is an efficient therapeutic in CF during its first year of administration, however its long-term efficacy remains questionable.
The authors suggest that “other still undefined aspects of the use of Az include the possible emergence of antibiotic resistance in the other bacterial pathogens that usually colonize CF patients, the real incidence of adverse events and the drug’s potential interference with other routine therapies.”
Estimations show that Cystic fibrosis (CF) affects about 1 in 2,500 newborns, and is considered the most frequent inherited disease in caucasian populations. CF is an autosomal recessive disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which is responsible for a protein that regulates liquid volume on epithelial surfaces by means of chloride secretion and the inhibition of sodium absorption.