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Vol. 46. Issue 5.
Pages 244-254 (May 2010)
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Vol. 46. Issue 5.
Pages 244-254 (May 2010)
Review article
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Usefulness of Macrolides as Anti-inflammatories in Respiratory Diseases
Utilidad de los macrólidos como antiinflamatorios en las enfermedades respiratorias
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Daniel Sevilla-Sáncheza,
Corresponding author
danielsevillasanchez@gmail.com

Corresponding author.
, Dolors Soy-Munera,b, Néstor Soler-Porcarb,c
a Servicio de Farmacia, Hospital Clínic de Barcelona, Barcelona, Spain
b CIBER de Enfermedades Respiratorias, Hospital Clínic de Barcelona, Barcelona, Spain
c Servicio de Neumología, Institut Clínic del Tórax, Hospital Clínic de Barcelona, Barcelona, Spain
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Abstract

The macrolides are antibiotics that, besides their anti-bacterial action, have an anti-inflammatory effect, by decreasing the activity of the immune cells and bacteria cell changes.

An increase the survival of patients suffering from diffuse panbronchiolitis was already seen in the 1980s, after being treated with erythromycin. Currently, the use of macrolides in various chronic inflammatory diseases has increased significantly. Clinical improvements associated to the administration of macrolides have been observed in diseases such as, cystic fibrosis, asthma, and bronchiectasis.

However, despite the apparent clinical benefit they seem to provide, the published results up until now are controversial and conclusive results are unable to be obtained. This means that further clinical trials are necessary to confirm or refute the long-term use of these drugs, which are not free of adverse effects, mainly the appearance of resistant bacteria.

Keywords:
Macrolides
Antibiotic
Anti-inflammatory
Respiratory disease
Microbial resistance
Resumen

Los macrólidos son antibióticos que además de su acción antibacteriana pueden presentar un cierto efecto antiinflamatorio por disminución de la actividad de las células inmunitarias y alteración de las células bacterianas.

Ya en los años 80 se observó un aumento de la supervivencia en pacientes afectados de panbronquiolitis difusa después de tratarse con eritromicina. En la actualidad, el uso de macrólidos en diferentes enfermedades de carácter inflamatorio crónico ha aumentado significativamente. En la fibrosis quística, el asma, las bronquiectasias, entre otras, se han observado mejoras clínicas asociadas a la administración de macrólidos.

Sin embargo, y a pesar del aparente beneficio clínico que parecen aportar, los resultados publicados hasta la fecha son controvertidos y no permiten obtener resultados concluyentes. Esto hace necesario realizar futuros ensayos clínicos para confirmar o rebatir el uso a largo plazo de estos fármacos, que no están exentos de efectos adversos, principalmente la aparición de especies bacterianas resistentes.

Palabras clave:
Macrólidos
Antibiótico
Antiinflamatorio
Enfermedad respiratoria
Resistencias microbianas
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