• Michael J Parnham, Ognjen Culić, Vesna Eraković, Vesna Munić, Sanja Popović-Grle, Karmela Barisić, Martina Bosnar, Karmen Brajsa, Ivana Cepelak, Snjezana Cuzić, Ines Glojnarić, Zoran Manojlović, Renata Novak-Mircetić, Katarina Oresković, Verica Pavicić-Beljak, Senka Radosević, and Mirna Sucić.
• PLIVA Research Institute Ltd, Prilaz baruna Filipovića 29, HR-10 000 Zagreb, Croatia. michael.parnham@pliva.hr
• Eur. J. Pharmacol. 2005 Jul 4;517(1-2):132-43.

AbstractThe anti-inflammatory potential of azithromycin in chronic obstructive pulmonary disease (COPD) patients was explored following a standard oral dosing regimen. Patients with moderate and severe COPD were treated with azithromycin (500 mg, n=16) or placebo (n=8) once daily for 3 days in a randomized, double blind design, to compare effects on inflammation markers with those seen in a previous study in healthy volunteers. A battery of tests was made on serum, blood neutrophils and sputum on days 1 (baseline), 3, 4, 11, 18 and 32. In comparison to placebo, azithromycin resulted in an early transient increase in serum nitrites plus nitrates (day 3), associated with a tendency towards an increase in the blood neutrophil oxidative burst to phorbol myristic acetate. Subsequently, prolonged decreases in blood leukocyte and platelet counts, serum acute phase protein (including C reactive protein) and soluble E-selectin and blood neutrophil lactoferrin concentrations and a transient decrease in serum interleukin-8 were observed. Blood neutrophil glutathione peroxidase activity showed a prolonged increase after azithromycin treatment. The biphasic facilitatory-then-inhibitory response to azithromycin seen in healthy volunteers is not so clearly detectable in COPD patients, only potential anti-inflammatory effects. Treatment for longer periods may give therapeutic anti-inflammatory benefit in these patients.

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