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Effect of clarithromycin on experimental rhinovirus-16 colds: a randomized, double-blind, controlled trial.

Abstract

PURPOSE

Macrolide antibiotics are frequently prescribed to patients with symptoms of a common cold. Despite their lack of proven antiviral activity, macrolide antibiotics may have anti-inflammatory actions, such as inhibition of mucus secretion and production of interleukins 6 and 8 by epithelial cells. Because the symptoms of rhinovirus colds are attributed to the inflammatory response to infection, we studied the effects of treatment with clarithromycin on the symptomatic and inflammatory response to nasal inoculation with rhinovirus.

SUBJECTS AND METHODS

We performed a prospective, double-blind, controlled trial in 24 healthy subjects who were seronegative for antibodies to rhinovirus-16. Subjects were randomly assigned to receive either clarithromycin (500 mg) or trimethoprim-sulfamethoxazole (800/160 mg, as a control antibiotic) twice a day for 8 days, beginning 24 hours before inoculation with rhinovirus-16.

RESULTS

All 12 subjects in each group were infected and developed symptomatic colds. The groups did not differ in the intensity of cold symptoms (median [25th to 75th percentile] score in the clarithromycin group of 25 [5 to 33] versus 21 [11 to 26] in the trimethoprim-sulfamethoxazole group, P = 0.86), weight of nasal secretions (25 g [8 to 56 g] versus 12 g [5 to 28 g], P = 0.27), or decline in nasal peak flow during the 8 days following viral inoculation. In both groups, similar and significant increases from baseline were observed in the numbers of total cells and neutrophils, and in the concentrations of interleukins 6 and 8, in nasal lavage fluid during the cold. The changes that we observed did not differ from those in an untreated historical control group.

CONCLUSIONS

We conclude that clarithromycin treatment has little or no effect on the severity of cold symptoms or the intensity of neutrophilic nasal inflammation in experimental rhinovirus-16 colds.

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  • Authors+Show Affiliations

    ,

    Division of Allergy and Immunology, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA.

    , , , , ,

    Source

    The American journal of medicine 108:6 2000 Apr 15 pg 453-9

    MeSH

    Adult
    Anti-Bacterial Agents
    Anti-Infective Agents
    Clarithromycin
    Common Cold
    Double-Blind Method
    Female
    Humans
    Inflammation
    Interleukin-6
    Interleukin-8
    Leukocyte Count
    Male
    Nasal Lavage Fluid
    Neutrophils
    Prospective Studies
    Rhinovirus
    Severity of Illness Index
    Trimethoprim, Sulfamethoxazole Drug Combination

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    10781777

    Citation

    Abisheganaden, J A., et al. "Effect of Clarithromycin On Experimental Rhinovirus-16 Colds: a Randomized, Double-blind, Controlled Trial." The American Journal of Medicine, vol. 108, no. 6, 2000, pp. 453-9.
    Abisheganaden JA, Avila PC, Kishiyama JL, et al. Effect of clarithromycin on experimental rhinovirus-16 colds: a randomized, double-blind, controlled trial. Am J Med. 2000;108(6):453-9.
    Abisheganaden, J. A., Avila, P. C., Kishiyama, J. L., Liu, J., Yagi, S., Schnurr, D., & Boushey, H. A. (2000). Effect of clarithromycin on experimental rhinovirus-16 colds: a randomized, double-blind, controlled trial. The American Journal of Medicine, 108(6), pp. 453-9.
    Abisheganaden JA, et al. Effect of Clarithromycin On Experimental Rhinovirus-16 Colds: a Randomized, Double-blind, Controlled Trial. Am J Med. 2000 Apr 15;108(6):453-9. PubMed PMID: 10781777.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of clarithromycin on experimental rhinovirus-16 colds: a randomized, double-blind, controlled trial. AU - Abisheganaden,J A, AU - Avila,P C, AU - Kishiyama,J L, AU - Liu,J, AU - Yagi,S, AU - Schnurr,D, AU - Boushey,H A, PY - 2000/4/27/pubmed PY - 2000/6/24/medline PY - 2000/4/27/entrez SP - 453 EP - 9 JF - The American journal of medicine JO - Am. J. Med. VL - 108 IS - 6 N2 - PURPOSE: Macrolide antibiotics are frequently prescribed to patients with symptoms of a common cold. Despite their lack of proven antiviral activity, macrolide antibiotics may have anti-inflammatory actions, such as inhibition of mucus secretion and production of interleukins 6 and 8 by epithelial cells. Because the symptoms of rhinovirus colds are attributed to the inflammatory response to infection, we studied the effects of treatment with clarithromycin on the symptomatic and inflammatory response to nasal inoculation with rhinovirus. SUBJECTS AND METHODS: We performed a prospective, double-blind, controlled trial in 24 healthy subjects who were seronegative for antibodies to rhinovirus-16. Subjects were randomly assigned to receive either clarithromycin (500 mg) or trimethoprim-sulfamethoxazole (800/160 mg, as a control antibiotic) twice a day for 8 days, beginning 24 hours before inoculation with rhinovirus-16. RESULTS: All 12 subjects in each group were infected and developed symptomatic colds. The groups did not differ in the intensity of cold symptoms (median [25th to 75th percentile] score in the clarithromycin group of 25 [5 to 33] versus 21 [11 to 26] in the trimethoprim-sulfamethoxazole group, P = 0.86), weight of nasal secretions (25 g [8 to 56 g] versus 12 g [5 to 28 g], P = 0.27), or decline in nasal peak flow during the 8 days following viral inoculation. In both groups, similar and significant increases from baseline were observed in the numbers of total cells and neutrophils, and in the concentrations of interleukins 6 and 8, in nasal lavage fluid during the cold. The changes that we observed did not differ from those in an untreated historical control group. CONCLUSIONS: We conclude that clarithromycin treatment has little or no effect on the severity of cold symptoms or the intensity of neutrophilic nasal inflammation in experimental rhinovirus-16 colds. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/10781777/Effect_of_clarithromycin_on_experimental_rhinovirus_16_colds:_a_randomized_double_blind_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(00)00329-6 DB - PRIME DP - Unbound Medicine ER -