A few Azith studies

[kim]

http://www.ncbi.nlm.nih.gov/pubmed/1549953...0,f1000m,isrctn

 

Center for Immunology and Microbial Disease and Department of Pediatrics, Albany Medical College, Albany, New York 12208, USA. fernana@mail.amc.edu

 

Macrolide antibiotics, including azithromycin, have been implicated in the modulation of host immune responses, independently of their antimicrobial properties. The present work was designed to study the effect that azithromycin has on protective humoral immune responses induced by a 7-valent, polysaccharide, pneumococcal conjugate vaccine (PCV7). By use of a murine vaccination/challenge model, it was found that inoculation with azithromycin led to significantly lower primary antibody responses, decreased recall proliferative responses, and, in nasal cavities, impaired clearance of Streptococcus pneumoniae serotype 14 from the nasal cavities. The results demonstrate that azithromycin can be inhibitory with regard to protective immune responsiveness.

 

 

http://www.ingentaconnect.com/content/ben/...a420c21c2900e1a

 

Abstract:

 

Macrolide antibiotics are noted for their intracellular accumulation and activity against intracellular pathogens such as Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella spp. Apart from antimicrobial activities, macrolides can modify host cell functions. Indeed, several in vitro- and ex vivo-studies have shown that macrolides influence polymorphonuclear cell functions as well as cytokine production by several cell types. In this way macrolides may change host immune responses, and thus may be used as immunomodulating agents. Immunomodulation (i.e., therapy that modulates the immune response of the host) may serve as an important adjuvant to antibiotic therapy in the treatment of infectious diseases or infection-related illnesses in several ways: therapy may be aimed at upregulation of the inflammatory response in case the host response is too “weak”. Conversely, downregulation of inflammatory responses may protect the host against the deleterious consequences of immune hyper-activation, when the host response is too “vigorous”, or when the host response is too persistent.

 

The scope of this manuscript is to describe the effects of macrolides on innate immunity in the pulmonary compartment (i.e., the innate host defense during pulmonary infections and pulmonary (non-infectious) inflammation). We will first describe the various in vitro- and ex vivo-effects of macrolides; thereafter, we will give an overview of animal studies on non-antimicrobial activities of macrolides. Finally, usage of macrolides in panbronchiolitis and cystic fibrosis is highlighted. The approach of using antibiotics (e.g., macrolides) as immunomodulating agents, however, carries the risk of (respiratory tract) colonisation and possible clinical infection with antibiotic-resistance organisms.

 

 

http://www.ncbi.nlm.nih.gov/pubmed/1238366...0,f1000m,isrctn

 

Comment in:

Lancet. 2003 Jan 25;361(9354):349-50; aurhor reply 350.

 

Long term azithromycin in children with cystic fibrosis: a randomised, placebo-controlled crossover trial.

 

Equi A, Balfour-Lynn IM, Bush A, Rosenthal M.

 

Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK.

 

BACKGROUND: The macrolide antibiotic azithromycin has anti-inflammatory properties potentially beneficial in cystic fibrosis. Since findings of open pilot studies seemed to show clinical benefit, we undertook a formal trial. METHODS: 41 children with cystic fibrosis, aged 8-18 years, and with a median forced expiratory volume in 1 s (FEV1) of 61% (range 33-80%) participated in a 15-month randomised double-blind, placebo-controlled crossover trial. They received either azithromycin (bodyweight < or =40 kg: 250 mg daily, >40 kg: 500 mg daily) or placebo for 6 months. After 2 months of washout, the treatments were crossed over. The primary outcome was median relative difference in FEV1 between azithromycin and placebo treatment periods. Sputum cultures, sputum interleukin 8 and neutrophil elastase, exercise testing, quality of life, antibiotic use, and pulmonary exacerbation rates were secondary outcome measures. Side-effects were assessed by pure tone audiometry and liver function tests. Analysis was by intention-to-treat. FINDINGS: Median relative difference in FEV1 between azithromycin and placebo was 5.4% (95% CI 0.8-10.5). 13 of 41 patients improved by more than 13% and five of 41 deteriorated by more than 13% (p=0.059). Forced vital capacity and mid-expiratory flow did not significantly change overall. 17 of 41 patients had 24 fewer oral antibiotic courses when on azithromycin than when taking placebo, and five had six extra courses (p=0.005). Sputum bacterial densities, inflammatory markers, exercise tolerance, and subjective well-being did not change. There were no noticeable side-effects. INTERPRETATION: A 4-6-month trial of azithromycin is justified in children with cystic fibrosis who do not respond to conventional treatment. The mechanism of action remains unknown.

[melanie]

http://www.ncbi.nlm.nih.gov/pubmed/1549953...0,f1000m,isrctn

 

Center for Immunology and Microbial Disease and Department of Pediatrics, Albany Medical College, Albany, New York 12208, USA. fernana@mail.amc.edu

 

Macrolide antibiotics, including azithromycin, have been implicated in the modulation of host immune responses, independently of their antimicrobial properties. The present work was designed to study the effect that azithromycin has on protective humoral immune responses induced by a 7-valent, polysaccharide, pneumococcal conjugate vaccine (PCV7). By use of a murine vaccination/challenge model, it was found that inoculation with azithromycin led to significantly lower primary antibody responses, decreased recall proliferative responses, and, in nasal cavities, impaired clearance of Streptococcus pneumoniae serotype 14 from the nasal cavities. The results demonstrate that azithromycin can be inhibitory with regard to protective immune responsiveness.

 

 

http://www.ingentaconnect.com/content/ben/...a420c21c2900e1a

 

Abstract:

 

Macrolide antibiotics are noted for their intracellular accumulation and activity against intracellular pathogens such as Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella spp. Apart from antimicrobial activities, macrolides can modify host cell functions. Indeed, several in vitro- and ex vivo-studies have shown that macrolides influence polymorphonuclear cell functions as well as cytokine production by several cell types. In this way macrolides may change host immune responses, and thus may be used as immunomodulating agents. Immunomodulation (i.e., therapy that modulates the immune response of the host) may serve as an important adjuvant to antibiotic therapy in the treatment of infectious diseases or infection-related illnesses in several ways: therapy may be aimed at upregulation of the inflammatory response in case the host response is too “weak”. Conversely, downregulation of inflammatory responses may protect the host against the deleterious consequences of immune hyper-activation, when the host response is too “vigorous”, or when the host response is too persistent.

 

The scope of this manuscript is to describe the effects of macrolides on innate immunity in the pulmonary compartment (i.e., the innate host defense during pulmonary infections and pulmonary (non-infectious) inflammation). We will first describe the various in vitro- and ex vivo-effects of macrolides; thereafter, we will give an overview of animal studies on non-antimicrobial activities of macrolides. Finally, usage of macrolides in panbronchiolitis and cystic fibrosis is highlighted. The approach of using antibiotics (e.g., macrolides) as immunomodulating agents, however, carries the risk of (respiratory tract) colonisation and possible clinical infection with antibiotic-resistance organisms.

 

 

http://www.ncbi.nlm.nih.gov/pubmed/1238366...0,f1000m,isrctn

 

Comment in:

Lancet. 2003 Jan 25;361(9354):349-50; aurhor reply 350.

 

Long term azithromycin in children with cystic fibrosis: a randomised, placebo-controlled crossover trial.

 

Equi A, Balfour-Lynn IM, Bush A, Rosenthal M.

 

Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK.

 

BACKGROUND: The macrolide antibiotic azithromycin has anti-inflammatory properties potentially beneficial in cystic fibrosis. Since findings of open pilot studies seemed to show clinical benefit, we undertook a formal trial. METHODS: 41 children with cystic fibrosis, aged 8-18 years, and with a median forced expiratory volume in 1 s (FEV1) of 61% (range 33-80%) participated in a 15-month randomised double-blind, placebo-controlled crossover trial. They received either azithromycin (bodyweight < or =40 kg: 250 mg daily, >40 kg: 500 mg daily) or placebo for 6 months. After 2 months of washout, the treatments were crossed over. The primary outcome was median relative difference in FEV1 between azithromycin and placebo treatment periods. Sputum cultures, sputum interleukin 8 and neutrophil elastase, exercise testing, quality of life, antibiotic use, and pulmonary exacerbation rates were secondary outcome measures. Side-effects were assessed by pure tone audiometry and liver function tests. Analysis was by intention-to-treat. FINDINGS: Median relative difference in FEV1 between azithromycin and placebo was 5.4% (95% CI 0.8-10.5). 13 of 41 patients improved by more than 13% and five of 41 deteriorated by more than 13% (p=0.059). Forced vital capacity and mid-expiratory flow did not significantly change overall. 17 of 41 patients had 24 fewer oral antibiotic courses when on azithromycin than when taking placebo, and five had six extra courses (p=0.005). Sputum bacterial densities, inflammatory markers, exercise tolerance, and subjective well-being did not change. There were no noticeable side-effects. INTERPRETATION: A 4-6-month trial of azithromycin is justified in children with cystic fibrosis who do not respond to conventional treatment. The mechanism of action remains unknown.

 

 

 

 

 

Sorry but is that good my son is on azith

[kim]

melanie,

 

I'm so sorry I totally missed your question on this thread. I think it's generally thought that azith is a pretty good bet for clearing strep, especially if amox or Keflex etc. isn't cutting it. My boys were given round after round of amox when they were younger. I kept asking if it might be a good idea to switch antibiotics and was told that amox was just like water on a fire where strep was concerned. In hind site, I should have asked why they needed it for 30 days at a time, if that was the case, but in those days i never questioned a Dr. I was secure in the "they know best," mindset.

 

Hopefully one of the parents with more experience will help you out with this question. It would be nice to know how long your son has been taking zith, what dose and history of anti biotics tried. I'm sorry I don't remember your son's story exactly (if you have already posted this info)