A pilot study of low-dose erythromycin in bronchiectasis

Patients with bronchiectasis suffer from sputum production, recurrent exace rbations, and progressive airway destruction. Erythromycin is effective in diffuse panbronchiolitis, another suppurative airway disorder, although its efficacy is unknown in idiopathic bronchiectasis. A double-blind placebo-controlled study was therefore conducted to evaluate the effects of 8-week administration of low dose erythromycin (500 mg b.i. d.) in steady-state idiopathic bronchiectasis. Patients in the erythromycin group (n=11, 8 female, mean age 50+/-15 yrs), but not the placebo group (n=10, 8 female, mean age 59+/-16 yrs) had signif icantly improved forced expiratory volume in one second, forced vital capac ity and 24-h sputum volume after 8 weeks (p<0.05),There was no parallel imp rovement in sputum pathogens, leukocytes, interleukin (IL)-1 alpha and IL-8 , tumour necrosis factor-alpha, or leukotriene B4, The results of this pilot study show that low-dose erythromycin improves lu ng function and sputum volume in bronchiectasis. Further studies are indica ted to evaluate the efficacy of long-term erythromycin therapy in bronchiec tasis.