open access
Organizing pneumonia - clarithromycin treatment
open access
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.
Keywords
cryptogenic organizing pneumonia; antibiotic therapy; corticosteroid therapy; clarithromycin


Title
Organizing pneumonia - clarithromycin treatment
Journal
Advances in Respiratory Medicine
Issue
Article type
Research paper
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