During the recent years there has been increasing interest in the potential anti-inflammatory effects of macrolide antibiotics. The use of long time and low dose macrolide antibiotics has dramatically increased survival in patients with diffuse pan bronchiolitis. This has led to further studies into the potential use of macrolides in chronic inflammatory lung diseases. This review summarizes the proposed anti-inflammatory mechanisms of macrolide antibiotics such as the effects of macrolide antibiotics on the inflammatory cytokine expression, the modulation of these antibiotics on neutrophil and macrophage function, on mucus secretion, and on bacterial adherence. It also discusses the clinical studies of macrolide antibiotics in patients with chronic inflammatory lung diseases such as cystic fibrosis, bronchiectasis, chronic obstructive pulmonary disease and asthma. Many randomized controlled clinical trials have showed the potential benefits of this group of antibiotics, however, it needs to perform futher studies before routines use can be advised.
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