Long-term efficacy and safety of clarithromycin treatment in patients with diffuse panbronchiolitis

Respir Med. 2003 Jul;97(7):844-50. doi: 10.1016/s0954-6111(03)00042-8.


Diffuse panbronchiolitis (DPB) can now be cured with long-term erythromycin treatment. Our group conducted a prospective open trial of long-term treatment with a macrolide antibiotic, clarithromycin. We studied ten patients who were treated for 4 years with oral clarithromycin (200 mg once a day). Pulmonary function test, blood gas analysis, comprehensive improvement score, and bacterial culture of sputum were examined at 3, 6, 12 months, and at 2, 3, 4 years after the initiation of the therapy. Pulmonary function improved in most of the patients within 6 months: the forced expiratory volume in one second showed a maximal increase from a mean (SE) value of 1.74 (0.12) l at baseline to 2.31 (0.22) l at 6 months (P < 0.01) and the volume (l) of forced vital capacity also showed a maximal increase within 6 months. The partial pressure of arterial oxygen at rest significantly increased at 3-6 months. The comprehensive improvement score also reached maximum within 6 months in nine of the patients. The majority of patients have developed sputum culture in which bacteria were negative within 6 months after the therapy. All of the patients maintained a stable condition with continued therapy, and no side effects of clarithromycin were observed during the study. This prospective study demonstrated that 6-month treatment with clarithromycin might be necessary to improve the clinical conditions of patients with DPB and the drug could be safely used for a long term.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Anti-Bacterial Agents / therapeutic use*
  • Bronchiolitis / drug therapy*
  • Bronchiolitis / microbiology
  • Bronchiolitis / physiopathology
  • Clarithromycin / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Humans
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Respiratory Function Tests
  • Sputum / microbiology
  • Time Factors


  • Anti-Bacterial Agents
  • Clarithromycin