open access

Vol 76, No 5 (2008)
ORIGINAL PAPERS
Published online: 2008-09-17
Submitted: 2013-02-22
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Organizing pneumonia - clarithromycin treatment

Elżbieta Radzikowska, Elżbieta Wiatr, Dariusz Gawryluk, Renata Langfort, Iwona Bestry, Mariusz Chabowski, Kazimierz Roszkowski
Pneumonol Alergol Pol 2008;76(5):334-339.

open access

Vol 76, No 5 (2008)
ORIGINAL PAPERS
Published online: 2008-09-17
Submitted: 2013-02-22

Abstract


Introduction: Organizing pneumonia (OP) is a rare syndrome that has been associated with a variety of underlying factors including infections, collagen vascular diseases, toxic fumes, cancer, drugs and radiotherapy. A cryptogenic form is also observed. OP is a curable disease in the most cases. Steroids are the standard therapy, but other treatment regimens have been used as well.
Material and methods: In the period from 1999 to 2005, 9 women and 3 men (age range 44-71 years) with OP were selected for the study. There were 9 non-smokers, 2 smokers and 1 ex-smoker. Open lung biopsy was performed in 5 patients, and in 7 patients diagnosis was established on the basis of transbronchial lung biopsy.
Results: Dyspnoea (100%), cough (100%), weakness (100%), fever (83%), loss of weight (83%), sweats (33%) and chest pain (8%) were the most frequently noticed symptoms. Radiographically, all patients had bilateral consolidations with areas of ground glass attenuations. A migratory pattern of these lesions was observed in 9 (75%) patients. In all patients clarithromycin (CLA) in a dose 0.5 g b.i.d was administered. Nine (75%) patients were successfully treated. Complete clinical and radiological remission was obtained after 3 months of CLA therapy in 7 and a partial response in an additional 2 patients, in whom treatment was prolonged to 4 months. During the first month of CLA treatment 3 patients did not respond to the therapy, and prednisone was introduced. The observation period ranged from 30 to 90 months (mean 42 months). Adverse reaction to CLA and relapse did not occur.
Conclusions: OP can be treated with clarithromycin. It may be an alternative treatment, particularly for patients in good clinical status and in whom the probability of adverse events in the course of corticotherapy is high.

Abstract


Introduction: Organizing pneumonia (OP) is a rare syndrome that has been associated with a variety of underlying factors including infections, collagen vascular diseases, toxic fumes, cancer, drugs and radiotherapy. A cryptogenic form is also observed. OP is a curable disease in the most cases. Steroids are the standard therapy, but other treatment regimens have been used as well.
Material and methods: In the period from 1999 to 2005, 9 women and 3 men (age range 44-71 years) with OP were selected for the study. There were 9 non-smokers, 2 smokers and 1 ex-smoker. Open lung biopsy was performed in 5 patients, and in 7 patients diagnosis was established on the basis of transbronchial lung biopsy.
Results: Dyspnoea (100%), cough (100%), weakness (100%), fever (83%), loss of weight (83%), sweats (33%) and chest pain (8%) were the most frequently noticed symptoms. Radiographically, all patients had bilateral consolidations with areas of ground glass attenuations. A migratory pattern of these lesions was observed in 9 (75%) patients. In all patients clarithromycin (CLA) in a dose 0.5 g b.i.d was administered. Nine (75%) patients were successfully treated. Complete clinical and radiological remission was obtained after 3 months of CLA therapy in 7 and a partial response in an additional 2 patients, in whom treatment was prolonged to 4 months. During the first month of CLA treatment 3 patients did not respond to the therapy, and prednisone was introduced. The observation period ranged from 30 to 90 months (mean 42 months). Adverse reaction to CLA and relapse did not occur.
Conclusions: OP can be treated with clarithromycin. It may be an alternative treatment, particularly for patients in good clinical status and in whom the probability of adverse events in the course of corticotherapy is high.
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Keywords

cryptogenic organizing pneumonia; antibiotic therapy; corticosteroid therapy; clarithromycin

About this article
Title

Organizing pneumonia - clarithromycin treatment

Journal

Advances in Respiratory Medicine

Issue

Vol 76, No 5 (2008)

Pages

334-339

Published online

2008-09-17

Bibliographic record

Pneumonol Alergol Pol 2008;76(5):334-339.

Keywords

cryptogenic organizing pneumonia
antibiotic therapy
corticosteroid therapy
clarithromycin

Authors

Elżbieta Radzikowska
Elżbieta Wiatr
Dariusz Gawryluk
Renata Langfort
Iwona Bestry
Mariusz Chabowski
Kazimierz Roszkowski

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