Long-term macrolide therapy; oropharyngeal dysbiosis and the spread of resistant pathogens

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Use of macrolide therapy for chronic lung diseases is increasing rapidly. We will determine the impact of long-term macrolide antibiotic use on upper airway bacteria in patients with lung disease, and assess its contribution to antibiotic resistance in the wider community. We will investigate the mechanism by which this therapy achieves benefit and assess interference with bacterial signalling as a means to improve treatment efficacy and reduce induction of antibiotic resistance.