Clarithromycin for safe and cost-effective reduction of cyclosporine dosesin lung allograft recipients

Background. This study was done to analyze tho economic effect of clarithro mycin on the daily dosing of cyclosporine in lung transplantation. Methods. Nine consecutive patients (mean age +/- SEM, 34.6 +/- 5.2 years) h ad transplantation from June 1995 to June 1996. Median follow-up time was 6 49 days (range, 431 to 799 days). Preoperative diagnoses were cystic fibros is (n = 4), idiopathic pulmonary fibrosis (n = 2), emphysema, bronchiectasi s, and obliterative bronchiolitis. Median time from transplantation to addi tion of clarithromycin to a standard immunosuppressive regimen was 86 days (range, 14 to 181 days). Results. Baseline cyclosporine dose (9.9 +/- 2.2 mg/kg/day) was reduced to 5.8 +/- 1.0 mg/kg/day and 4.1 +/- 0.8 mg/kg/day at 1 month and 1 year, resp ectively, after initiation of clarithromycin therapy Estimated annual savin gs were $3,400 per patient. There was no increase in infection or rejection episodes. Conclusions. Clarithromycin safely reduced the dose and cost of cyclosporin e in this series.