Clarithromycin attenuates mastectomy-induced acute inflammatory response

Based on the observation that administration of clarithromycin led to an at tenuation of the inflammatory response induced by surgical trauma in a guin ea pig model, we investigated the potential beneficial effects of clarithro mycin on the local and systemic inflammatory response in patients undergoin g mastectomy in an open-label prospective study. During a 16-month period, 54 patients who underwent mastectomy were randomly divided into two groups. In one group, the patients received oral clarithromycin at a dose of 500 m g twice a day, from the day before to 3 days after mastectomy. There was no significant difference in the incidence of antibiotic prophylaxis-related toxicities or postoperative infections between the patients who received cl arithromycin and those who did not, Clarithromycin treatment was significan tly associated with an attenuation of febrile response, tachycardia, tachyp nea, and an increase in monocyte counts (P, <0.0001, <0.01, <0.05, and <0.0 1, respectively). Clarithromycin also reduced the intensity and duration of postoperative pain (P, <0.05 and <0.005, respectively) and increased the r ange of motion of the involved shoulder (P < 0.05 for abduction and flexion ). We conclude that clarithromycin effectively modulates the acute inflamma tory response associated with mastectomy and produces a better clinical out come.