Trial of roxithromycin in subjects with asthma and serological evidence of infection with Chlamydia pneumoniae
Trial of roxithromycin in subjects with asthma and serological evidence of infection with Chlamydia pneumoniae
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DOI：
10.1164/ajrccm.164.4.2011040
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发表时间：
2001-08-15
影响因子：
24.7
通讯作者：
Allegra, L
中科院分区：
文献类型：
--
作者：
Black, PN;Blasi, F;Allegra, L
据报道，肺炎衣原体慢性感染与哮喘的严重程度之间存在关联，而且一些未经对照的观察结果表明，使用对肺炎衣原体有活性的抗生素进行治疗可改善哮喘的控制情况。我们研究了罗红霉素对哮喘患者且肺炎衣原体免疫球蛋白G（IgG）抗体滴度≥1∶64和/或免疫球蛋白A（IgA）抗体滴度≥1∶16的患者的疗效。共有232名来自澳大利亚、新西兰、意大利或阿根廷的受试者被随机分为两组，分别接受为期6周的罗红霉素（150mg，每日两次）治疗或安慰剂治疗。在6周结束时，罗红霉素组晚间呼气峰流速（PEF）较基线的增加值为15 L/min，安慰剂组为3 L/min（p = 0.02）。对于早晨的PEF，罗红霉素组增加值为14 L/min，安慰剂组为8 L/min（无显著差异）。在澳大拉西亚人群中，早晨PEP的增加值分别为18 L/min和4 L/min（p = 0.04）。在治疗结束后3个月和6个月时，两组之间的差异更小且无显著意义。罗红霉素治疗6周可改善哮喘的控制，但这种益处未持续。需要进一步研究以确定缺乏持续益处是否是由于未能根除肺炎衣原体。
An association has been reported between chronic infection with Chlamydia pneumoniae and the severity of asthma, and uncontrolled observations have suggested that treatment with antibiotics active against C. pneumoniae leads to an improvement in asthma control. We studied the effect of roxithromycin in subjects with asthma and immunoglobulin G (IgG) antibodies to C. pneumoniae greater than or equal to 1:64 and/or IgA antibodies greater than or equal to 1:16. A total of 232 subjects, from Australia, New Zealand, Italy, or Argentina, were randomized to 6 wk of treatment with roxithromycin 150 mg twice a day or placebo. At the end of 6 wk, the increase from baseline in evening peak expiratory flow (PEF) was 15 L/min with roxithromycin and 3 L/min with placebo (p = 0.02). With morning PEF, the increase was 14 L/min with roxithromycin and 8 L/min with placebo (NS). In the Australasian population, the increase in morning PEP was 18 L/min and 4 L/min, respectively (p = 0.04). At 3 mo and 6 mo after the end of treatment, differences between the two groups were smaller and not significant. Six weeks of treatment with roxithromycin led to improvements in asthma control but the benefit was not sustained. Further studies are necessary to determine whether the lack of sustained benefit is due to failure to eradicate C. pneumoniae.