Nonpecific bronchial hyperresponsiveness(BHR) is frequently associated with bronchiectasis and may have a role in its pathogenesis. Roxithromycin is a new semisynthetic macrolide antibiotic that also has antiinflammatory activities. This study
was
designed to see whether roxithromycin could favorably alter bronchial responsiveness in patients with bronchiectasis.
Twenty-six children with bronchiectasis were treated for eight weeks with roxithromycin, 4 ml/kg twice a day, orally. To estimate bronchial responsiveness, high-dose methacholine challenge tests were performed before and after treatment. On the
dose-response curve to methacholine. PC20 and maximal response, two indices of bronchial responsiveness, were measured.
In the methacholine test before roxithromycin treatment, twelve subjects were found to have BHR, defined as a PC20 <25mg/ml. This groups with (+) BHR had significantly higher maximal response than the 14 patients in the (-) BHR group. Changes in
FEV1
were not observed during the course of roxithromycin treatment. After eight weeks' treatment the geometric mean of PC20 increased significant and the mean of maximal response decreased significantly and the mean of maximal response decreased
significantly among patients in both groups, as compared with initial values. The magnitude of change in both parameters was statistically significant only in (+) BHR group.
Our results indicated that roxithromycin may decrease BHR in the patients with bronchiectasis. This finding suggests that roxithromycin might be a good agent in the long-term management. Of bronchiectasis, especially when accompanied by BHR.
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