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<identifier>oai:HAL:hal-01063927v1</identifier>
<datestamp>2015-02-21</datestamp>
<setSpec>type:ART</setSpec>
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<metadata><dc>
<publisher>HAL CCSD</publisher>
<title lang=en>[Long-term macrolide treatment in adult chronic bronchial diseases: benefits and limits]</title>
<creator>Jouneau, Stéphane</creator>
<creator>Desrues, Benoît</creator>
<contributor>Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; INSERM - École Nationale de la Santé Publique - Université de Rennes 1 (UR1) - Université des Antilles et de la Guyane (UAG) - Structure Fédérative de Recherche en Biologie-Santé de Rennes (Biosit) ; Université de Rennes 1 (UR1) - INSERM - CNRS - INSERM - CNRS</contributor>
<contributor>Service de pneumologie ; Hôpital Pontchaillou - CHU de Rennes</contributor>
<description>International audience</description>
<source>Presse Médicale (Paris, France: 1983)</source>
<identifier>hal-01063927</identifier>
<identifier>https://hal.archives-ouvertes.fr/hal-01063927</identifier>
<source>https://hal.archives-ouvertes.fr/hal-01063927</source>
<source>Presse Médicale (Paris, France: 1983), 2014, 43 (5), pp.510--519. <10.1016/j.lpm.2013.08.006></source>
<identifier>DOI : 10.1016/j.lpm.2013.08.006</identifier>
<language>en</language>
<subject lang=en>Adult</subject>
<subject lang=en>Asthma</subject>
<subject lang=en>Bronchiectasis</subject>
<subject lang=en>Chronic Disease</subject>
<subject lang=en>Humans</subject>
<subject lang=en>Macrolides</subject>
<subject lang=en>Pulmonary Disease</subject>
<subject lang=en>Chronic Obstructive</subject>
<subject lang=en>Time Factors</subject>
<subject>[SDV] Life Sciences</subject>
<type>Journal articles</type>
<description lang=en>Decreased frequency of pulmonary exacerbations, mainly related to immunomodulatory effects of macrolide antibiotics, has been demonstrated in bronchiectasis and chronic obstructive pulmonary diseases (COPD). Due to its tolerance, azithromycin is the antibiotic of choice for maintenance therapy at the dose of 250 mg per day or 500 mg × 3 per week (for body weight extgreater55 kg). Maintenance therapy with macrolide could be proposed in selected patients with bronchiectasis or COPD with more than 3 acute exacerbations in the previous year or decreased lung function despite compliance with optimum treatment. The risk of sudden cardiac death with azithromycin is rare and controversial. It should be avoided in patients with a high baseline risk of cardiovascular disease, QT extgreater450 msec, pulse rate extgreater100 bpm and potential drug interactions, particularly those known to cause QT prolongation. It is recommended to search for hearing deficit (audiometry) and sputum culture positive for mycobacteria. Patients must also be aware that it can rapidly lead to macrolide resistance in commensal or pathogenic flora. Follow-up evaluation every 3 month can be proposed with medical history (hearing deficit) and electrocardiography. After one year, the treatment should be stopped in the absence of reduction in the frequency of exacerbations.</description>
<date>2014</date>
</dc>
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