Long term low dose azithromycin prevents adherence of bacteria to cells.

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truehawk - 16 Apr 2007 02:41 GMT

Buccal adherence of Pseudomonas aeruginosa in patients with cystic
fibrosis under long-term therapy with azithromycin.

Baumann U, Fischer JJ, Gudowius P, Lingner M, Herrmann S, Tummler B,
von der Hardt H.
Dept. of Pediatric Pneumology and Neonatology, Hannover Medical
School, Germany. baumann.ulrich@mh-hannover.de

BACKGROUND: The oropharyngeal barrier is an innate host defence
mechanism to prevent bacterial Lung infection. A compromised barrier
function is observed in patients with cystic fibrosis (CF) who are
chronically infected with Pseudomonas aeruginosa. Macrolides are
assumed to modify host defence. We investigated the oropharyngeaL
barrier function in CF patients treated with azithromycin (AZM).
PATIENTS AND METHODS: In a prospective study, eleven chronically
infected children with CF were treated with longterm low-dose AZM. The
oropharyngeal barrier function was assessed by adherence of P.
aeruginosa (strain PACF 12-1) to buccal epithelial cells of the
patients before and after therapy. RESULTS: The mean (standard
deviation, SD) buccaL adherence before therapy was markedly high with
8.0 (4.8) bacteria/cell. Following therapy with AZM adherence
decreased in all patients by 70% or 5.6 to 2.4 (1.1) bacteria/cell (p
= 0.007), representing close to normal LeveLs (1.2 +/- 0.6).
CONCLUSION: Long-term low-dose AZM therapy may improve the compromised
oropharyngeaL barrier function in patients with CF, opening new
perspectives for early treatment of P. aeruginosa infection in CF.

PMID: 11261763 [PubMed - indexed for MEDLINE]

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truehawk - 16 Apr 2007 02:54 GMT

> Buccal adherence of Pseudomonas aeruginosa in patients with cystic
> fibrosis under long-term therapy with azithromycin.
[quoted text clipped - 24 lines]
>
> PMID: 11261763 [PubMed - indexed for MEDLINE]

[Macrolides, Pseudomonas aeruginosa and cystic fibrosis][Article in
French]
Guillot M, Amiour M, El Hachem C, Harchaoui S, Ribault V, Paris C.
Service de pediatrie et CRCM de Lisieux, CHG Robert-Bisson, 4, rue
Roger-Aini, 14100 Lisieux, France. m.guillot@ch-lisieux.fr

Long-term low dose azithromycin treatment in cystic fibrosis patients
with chronic Pseudomonas aeruginosa infection is safe and reduces the
decline in lung function, the number of acute exacerbations and
improves nutritional status; underlying efficacy mechanisms are
multiple and synergistic.

PMID: 17370396 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=17370396&query_hl=1&itool=pubmed_DocSum

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judy.n - 18 Apr 2007 18:05 GMT

Any idea of the dosing scheme? My ENT has empirically been using
azithromycin 250mg either 2x/week or weekly on a subset of patients,
with good results. My daughter is on the weekly dose, and it has been
very effective for her. Both journals are foreign, and I can't get
ahold of the full text, so I wanted to figure out the dosage.
Judy

> > Buccal adherence of Pseudomonas aeruginosa in patients with cystic
> > fibrosis under long-term therapy with azithromycin.
[quoted text clipped - 40 lines]
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&...

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Steven L. - 18 Apr 2007 18:27 GMT

> Any idea of the dosing scheme? My ENT has empirically been using
> azithromycin 250mg either 2x/week or weekly on a subset of patients,
> with good results.

Gee, where is Susan these days?

This sounds like a great way to cause the emergence of new resistant
superbugs--constantly expose the bacteria in patient's guts to low
levels of macrolide antibiotics. That's a great way to breed resistant
strains. Antibiotics should only be used in sufficient dose to wipe out
infections quickly and thoroughly--otherwise you are allowing bacteria a
chance to evolve resistance.

Hello, Susan, this sounds like something you should be griping about!

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Steven D. Litvintchouk
Email: sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

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judy.n - 18 Apr 2007 22:28 GMT

Steven,
Have you completely missed all of the articles about the anti-
inflammatory and anti-adherence properties of macrolides and to a
lesser extent, tetracyclines. These antibiotics are being used NOT for
antibacterial effect. There is a new formulation of doxycycline for
rosacea that has no antibiotic effect, only anti-inflammatory.
There's extensive literature to support the use of macrolides in
sinusitis, asthma and cystic fibrosis and NOT to treat infections.
We've been posting the references for months.Susan is well aware of
these, but somehow you've missed them.
Judy

> > Any idea of the dosing scheme? My ENT has empirically been using
> > azithromycin 250mg either 2x/week or weekly on a subset of patients,
[quoted text clipped - 15 lines]
> Email: sdlit...@earthlinkNOSPAM.net
> Remove the NOSPAM before replying to me.

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judy.n - 18 Apr 2007 18:11 GMT

Here's an article that defiines low dose azithromycin as either 250mg
(for <40kg) or 500mg (>40kg) three times a week.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=16809416&query_hl=7&itool=pubmed_docsum

Judy

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