The Efficacy and Safety of Azithromycin for Patients with Cystic Fibrosis: A Systematic Review
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Abstract
Chronic inflammation of the lungs is a major cause of morbidity and mortality in patients with cystic fibrosis. One of the macrolides, azithromycin has antimicrobial, immunomodulatory, and anti-inflammatory effects that are useful in diseases with chronic inflammatory processes such as cystic fibrosis. This systematic review aimed to determine the efficacy and safety of azithromycin administration for cystic fibrosis patients in improving lung function. Pulmonary function was assessed by measuring the value of forced expiratory volume in one second (FEV1) in patients after intervention. The process of searching literature through PUBMED and Cochrane Library uses the keywords "Cystic Fibrosis" and "Azithromycin" with the Boolean operator "AND". There were seven studies selected, with criteria RCT studies, patients of all ages, patients with cystic fibrosis, and compared azithromycin with placebo. After reviewing seven studies, 71.4% of the studies stated that there was a significant increase of mean FEV1 value after being given azithromycin therapy. Other outcomes assessed were FVC values, pro-inflammatory indicators, exacerbations, changes in body weight, and quality of life. Azithromycin administration is considered relatively safe and well-tolerated by patients.
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References
Acosta, N. et al. (2021) 'Azithromycin and the microbiota of cystic fibrosis sputum', BMC microbiology, 21(1). doi: 10.1186/S12866-021-02159-5.
Ahmed, S. et al. (2020) 'Cystic Fibrosis in Asia', Pediatric Respirology and Critical Care Medicine, 4(1), pp. 8–12.
De Boeck, K. (2020) 'Cystic fibrosis in the year 2020: A disease with a new face', Acta paediatrica (Oslo, Norway : 1992), 109(5), pp. 893–899. doi: 10.1111/APA.15155.
Clement, A. et al. (2006) 'Long Term Effects of Azithromycin in Patients with Cystic Fibrosis: A Double Blind', Placebo Controlled Trial. Thorax, 61(10), pp. 895–902.
Equi, A. et al. (2002) 'Long Term Azithromycin in Children with Cystic Fibrosis: a Randomised, Placebo-controlled Crossover Trial', The Lancet, 28;360(933, pp. 978–984.
Fonseca, C. et al. (2020) 'Cystic fibrosis: Physiopathology and the latest pharmacological treatments', Pharmacological research, 162. doi: 10.1016/J.PHRS.2020.105267.
Hay, W. W. et al. (2009) Current diagnosis & treatment: Pediatrics. McGraw-Hill Medical.
Jaffe, A. et al. (1998) 'Long-term azithromycin may Improve Lung Function in Children with Cystic Fibrosis', The Lancet, 351(9100).
Klimova, B. et al. (2017) 'Cystic Fibrosis Revisited - a Review Study', Medicinal chemistry (Shariqah (United Arab Emirates)), 13(2), pp. 102–109. doi: 10.2174/1573406412666160608113235.
Mayer-Hamblett, N. et al. (2018) 'Azithromycin for Early Pseudomonas Infection in Cystic Fibrosis', The OPTIMIZE Randomized Trial. American Journal of Respiratory and Critical Care, Medicine.1, pp. 1177–1187.
Patel, S. D., Bono, T. R. and Rowe, S. M. (2020) 'CFTR Targeted Therapies : Recent Advances in Cystic Fibrosis and Possibilities in Other Disease of The Airways', Eur Respi Rev, 20, p. 190068.
Principi, N., Blasi, F. and Esposito, S. (2015) 'Azithromycin use in patients with cystic fibrosis', European Journal of Clinical Microbiology & Infectious Diseases, 34(6), pp. 1071–1079.
Rafeeq, M. M. and Murad, H. A. S. (2017) 'Cystic fibrosis: current therapeutic targets and future approaches', Journal of translational medicine, 15(1). doi: 10.1186/S12967-017-1193-9.
Saiman, L. et al. (2003) 'Macrolide Study Group. Azithromycin in Patients with Cystic Fibrosis Chronically Infected with Pseudomonas aeruginosa: A Randomized Controlled Trial', Jama, 290(13), pp. 1749–1756.
Samson, C. et al. (2016) 'Long-term Effects of Azithromycin in Patients with Cystic Fibrosis', Respiratory Medicine, 1(117), pp. 1–6.
Savant, A. P. and McColley, S. A. (2019) 'Cystic fibrosis year in review 2018, part 1', Pediatric pulmonology, 54(8), pp. 1117–1128. doi: 10.1002/PPUL.24361.
Steinkamp, G. et al. (2018) 'Once-weekly Azithromycin in Cystic Fibrosis with Chronic Pseudomonas aeruginosa Infection', Respiratory Medicine, 102(11), pp. 1643–1653.
Thornton, C., Chin, M. and Somayaji, R. (2021) 'Azithromycin and Tobramycin Therapy in Cystic Fibrosis Pulmonary Exacerbations: Less Is More?', Annals of the American Thoracic Society, 18(2), pp. 213–215. doi: 10.1513/ANNALSATS.202009-1227ED.
Wolter, J. et al. (2002) 'Effect of Long Term Treatment with Azithromycin on Disease Parameters in Cystic Fibrosis: A Randomised Trial', Thorax, 57(3), pp. 212–216.
