Effect of azithromycin on systemic markers of inflammation in cystic fibrosis patients uninfected with Pseudomonas aeruginosa
Chest, 05/21/2012  Clinical Article

Ratjen F et al. – In patients not infected with P. aeruginosa, oral azithromycin significantly reduced neutrophil counts and serum inflammatory markers within 28 days of initiating treatment.

• White cell counts and differential, serum myeloperoxidase (MPO), high sensitivity C reactive protein (hsCRP), intracellular adhesion molecule 1 (ICAM 1), interleukin 6 (IL–6), calprotectin, serum amyloid A (SAA), and granulocyte colony stimulating factor (G–CSF) were measured at baseline, after 28 and 168 days of treatment in patients receiving either oral azithromycin or placebo.

• Inflammatory markers were similar in both groups at baseline.
• HsCRP, MPO, SAA, and calprotectin, as well as the absolute neutrophil count (ANC), significantly decreased from baseline to Day 28 in the azithromycin group as compared to the placebo group (p < 0.05).
• This treatment effect was sustained at Day 168 for ANC, calprotectin and SAA (p < 0.05).
• Changes in hsCRP, calprotectin and SAA at day 28 were negatively correlated with changes in FEV1 (L) and FEV1 (% predicted) as well as both absolute and relative changes in weight (p < 0.05).
• Except for weight (%), the associations remained significant for calprotectin; FEV1(L) and weight (%) remained significantly correlated with 168–day change in hsCRP.
• The 168–day change in ANC was significantly correlated with changes in lung function, but not in weight; the change in G–CSF was significantly correlated with the change in weight (%) only.