Macrolide Antibiotics for Prevention of Chronic Obstructive Pulmonary Disease Exacerbations: Are We There Yet?

摘要

Chronic obstructive pulmonary disease (COPD) exacerbations are associated with significant morbidity and mortality (1). Among the major goals of COPD treatment is the prevention of exacerbations (2). Clinical studies have shown that long-term continuous or intermittent use of antibiotics reduces COPD exacerbation frequency and extends the time to the next event (3, 4). Among antibiotic classes, macrolides are highlighted on the basis of well-designed randomized controlled trials (5-8). Although macrolides are known to have not only antibacterial but also antiinflammatory, immunomodulatory, and antiviral effects (9, 10), the mechanisms responsible for their clinical efficacy in preventing COPD exacerbations are unclear.