Azithromycin in bronchiolitis obliterans complicating bone marrow transplantation: a preliminary study

Authors:
  • ASA. Al Saghir
    A. Al Saghir
  • SDS. Al Dammas
    S. Al Dammas
  • MZM. Zeitouni
    M. Zeitouni
  • AMA. Al Mobeireek
    A. Al Mobeireek
  • NCN. Chaudhry
    N. Chaudhry
  • ESE. Sahovic
    E. Sahovic
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Abstract
Bronchiolitis obliterans (BO) is a serious noninfectious pulmonary complication following allogeneic bone marrow transplantation (BMT). Azithromycin, a macrolide antibiotic, may have a beneficial effect in BO through its anti-inflammatory effect. The aim of the current study was to investigate the potential effect of azithromycin on pulmonary function tests (PFTs) in BO complicating BMT.PFTs of 153 post-BMT patients were followed; eight patients out of 153 (12%) developed obstructive airway disease on their PFTs, along with characteristic findings of BO on high-resolution computed tomography of the chest. These patients were given azithromycin 500 mgq.d.for 3 days, followed by 250 mg three times a week for 12 weeks.Clinically significant improvements were achieved both in forced vital capacity, where the mean (95% confidence interval) increase reported was 410 mL (0.16–0.65), which was an average improvement of 21.57%, and in the forced expiratory volume in one second, where the mean increase noticed was 280 mL (0.10–0.44), which was an average improvement of 20.58%.In conclusion, the potential role of azithromycin in the treatment of bronchiolitis obliterans is intriguing and it warrants further testing.

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