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DOES TELITHROMYCIN EXHIBIT IMMUNOMODULATORY PROPERTIES IN CHRONIC AIRWAY INFLAMMATION?

Tanta Int’l Cardiothoracic Vascular Center, Tanta, Egypt

PURPOSE: The role of telithromycin in the treatment of respiratory tract infections is well established. However, telithromycin seems to have immunomodulatory properties in chronic airway inflammation, including the inflammatory allergic condition bronchial asthma. The aim of this trial was to establish whether our clinical observation of an extended 1-2 months treatment with telithromycin in patients with chronic inflammatory airway disorder is beneficial.

METHODS: Open comparative clinical trial with male and female patients aged 18-65 years with persistent cough, chronic obstructive bronchitis (with and without acute exacerbations), COPD or bronchial asthma. We compared post-treatment symptomatic relief and peak flow meter results with baseline recordings, while monitoring for adverse events, including abnormal laboratory values.

RESULTS: 84 patients (46 males, 38 females, age 37.3 ± 8.4 years) were enrolled. After 60 days of treatment (47.3 ± 3.2 days), symptomatic relief and improved spirometry were significantly better (p<0.05) than baseline recordings. The main adverse events were diarrhea and dizziness.

CONCLUSION: Telithromycin may have a role in the treatment of chronic airway inflammatory conditions including bronchial asthma. This may be explained by its high tissue penetration characteristic, and the increasing evidence that atypical respiratory pathogens (Mycoplasma pneumonia, Moraxella catarrhalis, and Legionella pneumophila), against which telithromycin is reportedly active, play a major role in the pathogenesis and prognosis of chronic inflammatory airway disorders.

CLINICAL IMPLICATIONS: Extended treatment with telithromycin may provide further benefits to patients with chronic airway inflammation, especially where atypical respiratory pathogens are suspected.

DISCLOSURE: Abdalla Abu Hussein, None.