NON-ANTIBACTERIAL EFFECTS OF MACROLIDE ANTIBIOTICS AND THEIR ROLE IN THE TREATMENT OF BRONCHIAL ASTHMA. REVIEW OF THE LITERATURE AND THE RESULTS OF OWN RESEARCH

Today there is a little evidence to confirm or disprove the benefits of routine long-term use of macrolide antibiotics in asthma. From the first trial till today one may say that this group of antibiotics have also non-antibacterial effects and can be useful for the treatment of asthma. But in order to raise resistance and some side effects, macrolides are not recommended for long-term use. Subacute infections with atypical bacteria including M. pneumoniae and C. pneumoniae contribute to poor asthma control. Infection diagnosed with PCR studies from bronchoscopy samples (biopsy, brushing and BAL) can identify an asthma phenotype that has a favorable response to macrolide therapy.

In our study, we tried to find the methods to identify atypical infections that are most informative in patients with bronchial asthma. The 35% of seropositive severe bronchial asthma patients and the 10.52% of of seropositive mild bronchial asthma patients have been revealed by group-specific test-system for blood serologic assessment. The positive title of antibodies IgG to Chlamydia pneumoniae has been revealed in 6 (18.75%) patients with severe bronchial asthma course by species-specific test-system. There were 9 (30%) of the same patients in the mild bronchial asthma group.

A comparative analysis group-specific and video-specific test systems proved that video specific test system has significant advantages in the diagnosis of Chlamydia pneumoniae infection in patients with asthma. In the case of a positive result for this category of patients, it is recommended treatment with drugs which are active with respect to Chlamydia pneumoniae, in particular with macrolides antibiotics.