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Long-term clarithromycin therapy in the management of lung transplant recipients


Benden, C; Boehler, A (2009). Long-term clarithromycin therapy in the management of lung transplant recipients. Transplantation, 87(10):1538-1540.

Abstract

BACKGROUND: The successful use of azithromycin in lung transplant recipients with Bronchiolitis Obliterans Syndrome (BOS) has been described, its mechanisms of action, however, are not known. We report the largest experience of long-term clarithromycin (CLAR) in lung transplant patients with BOS or potential BOS. METHODS: Transplant recipients receiving CLAR for BOS or potential BOS were included (2000-2008). Response to CLAR was defined as an FEV1 increase of >10% at 6 months compared to the FEV1 recorded at initiation of CLAR. RESULTS: 31 patients were included. 12 recipients (39%) responded to CLAR after 6 months, 10/12 recipients responded already after 3 months. Responders showed a mean FEV1 increase of 732 mL (95% CI: 537-938 mL) by 6 months (p<0.001). Overall, patients experienced a FEV1 decline of 181 mL/month prior to CLAR, and a 25 mL/month decline over the 6-months after initiation of CLAR; p=0.015, mean (95% CI) change in rate of decline 155 (32-279). DISCUSSION: We show that long-term CLAR effectively improves lung function in more than one-third of recipients with BOS or potential BOS, comparable to results reported with long-term azithromycin.

Abstract

BACKGROUND: The successful use of azithromycin in lung transplant recipients with Bronchiolitis Obliterans Syndrome (BOS) has been described, its mechanisms of action, however, are not known. We report the largest experience of long-term clarithromycin (CLAR) in lung transplant patients with BOS or potential BOS. METHODS: Transplant recipients receiving CLAR for BOS or potential BOS were included (2000-2008). Response to CLAR was defined as an FEV1 increase of >10% at 6 months compared to the FEV1 recorded at initiation of CLAR. RESULTS: 31 patients were included. 12 recipients (39%) responded to CLAR after 6 months, 10/12 recipients responded already after 3 months. Responders showed a mean FEV1 increase of 732 mL (95% CI: 537-938 mL) by 6 months (p<0.001). Overall, patients experienced a FEV1 decline of 181 mL/month prior to CLAR, and a 25 mL/month decline over the 6-months after initiation of CLAR; p=0.015, mean (95% CI) change in rate of decline 155 (32-279). DISCUSSION: We show that long-term CLAR effectively improves lung function in more than one-third of recipients with BOS or potential BOS, comparable to results reported with long-term azithromycin.

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23 citations in Web of Science®
25 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Pneumology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:24 Feb 2010 14:25
Last Modified:05 Apr 2016 13:57
Publisher:Lippincott Wiliams & Wilkins
ISSN:0041-1337
Publisher DOI:https://doi.org/10.1097/TP.0b013e3181a492b2
PubMed ID:19461491

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