Anti-inflammatory effects of macrolides in lung disease

Pediatr Pulmonol. 2001 Jun;31(6):464-73. doi: 10.1002/ppul.1076.


During the past five decades there has been increasing interest in the potential anti-inflammatory effects of macrolide antibiotics. Low-dose macrolide therapy has dramatically increased survival in patients with diffuse panbronchiolitis, a disease with many similarities to cystic fibrosis (CF). This has led to further investigation into the potential use of macrolides in chronic lung diseases with an inflammatory component. This review summarizes the proposed anti-inflammatory mechanisms for this group of antibiotics, and examines the effect of macrolides on modulation of the inflammatory pathways, neutrophil function, bronchoconstriction, Pseudomonas biofilm, mucus rheology, bacterial adherence, and multidrug-resistant protein. It discusses the current status of clinical studies in children with CF, bronchiectasis, and asthma. While there are much in vitro data for different proposed anti-inflammatory effects, randomized controlled clinical trials in children with CF, bronchiectasis, and asthma are still just beginning. The benefits and potential side effects need to be determined before routine use can be advised.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Asthma / drug therapy
  • Asthma / immunology
  • Asthma / pathology
  • Biofilms
  • Bronchiectasis / drug therapy
  • Bronchiectasis / immunology
  • Bronchiectasis / pathology
  • Bronchiolitis / drug therapy
  • Bronchiolitis / immunology
  • Bronchiolitis / pathology
  • Bronchoconstriction
  • Cystic Fibrosis / drug therapy
  • Cystic Fibrosis / immunology
  • Cystic Fibrosis / pathology
  • Humans
  • Inflammation
  • Lung Diseases / drug therapy*
  • Lung Diseases / immunology
  • Lung Diseases / pathology
  • Macrolides
  • Neutrophils / immunology
  • Randomized Controlled Trials as Topic


  • Anti-Bacterial Agents
  • Macrolides