Effect of clarithromycin on acute asthma exacerbations in children: an open randomized study

Pediatric Allergy and Immunology, 04/16/2012

Koutsoubari I et al. – When added to regular treatment, a 3–wk course of clarithromycin was associated with an increase in the number of symptom–free days, reductions in the number and severity of days with loss of control following index episode, and a decrease in the duration of the initial asthma exacerbation.


  • This pilot, open-labeled, randomized, prospective study included 40 school-aged children, with intermittent or mild persistent asthma, presenting with an acute exacerbation.
  • Children were randomized to receive 15mg/kg of clarithromycin for 3wk, in addition to their regular (GINA-guided) exacerbation treatment.
  • The microbial trigger of exacerbations was assessed by serology and PCR.
  • Children were followed up with diary cards for 12wk; lung function was assessed at entry, 3, and 12wk after the exacerbation.


  • Children in the clarithromycin group had significantly more symptom-free days (78±2 vs. 69±6days, p<0.00001) and less total number of periods with loss of control (9 vs. 19, respectively, p=0.013) during the follow-up period, compared to controls.
  • Moreover, treated children presented reduced duration of the index episode (5.0±1 vs. 7.5±1days, p<0.00001).
  • Lung function did not differ between groups.

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