Macrolide Therapy in Respiratory Viral Infections

Table 1

Macrolide studies evaluating efficacy on various respiratory viral infection.

Virus	Study	Macrolide	Dose	Method	Parameter	Results	Ref
Rhinovirus
RV16	Abisheganaden et al. (2000)	Clarithromycin	500 mg	Clinical trial	Symptom, nasal peak flow, weight of nasal secretion, cytokines (IL-6, IL-8 in nasal lavage fluid)	No effect	[21]
RV14	Suzuki et al. (2001)	Bafilomycin A1	0.1 μM	In vitro (human tracheal epithelial cells)	RV titer, ICAM-1, cytokines (IL-1𝛽, IL-6, IL-8, TNF-𝛼)	Inhibition	[22]
RV14RV2	Suzuki et al. (2002)	Erythromycin	10 μM	In vitro (human tracheal epithelial cells)	RV titer, ICAM-1, cytokines (IL-1𝛽, IL-6, IL-8, TNF-𝛼)	Inhibition	[23]
RV16	Jang et al. (2006)	Clarithromycin	1, 10, 100 μM	In vitro (A549 cells)	RV titer, ICAM-1, cytokines (IL-1𝛽, IL-6, IL-8)	Inhibition	[24]
RV14	Inoue et al. (2008)	Erythromycin	10 μM	In vitro (human tracheal epithelial cells)	MUC5AC	inhibition	[25]
RV16	Wang et al. (2010)	Clarithromycin	10 μM	In vitro (Nasal epithelial cell)	Fn, CEACAM, bacterial adhesion (S. aureus, H. influenza)	Inhibition	[26]
RV16RV1b	Gielen et al. (2010)	Azithromycin, Erythromycin, Telithromycin	10 μM	In vitro (Human bronchial epithelial cells)	mRNA of antiviral genes, type I IFN-𝛽, type III IFN-𝜆1, IFN-𝜆2/3, IFN-stimulated genes, cytokines (IL-6, IL-8), RV replication, RV release	Azithromycin: inhibition, erythromycin, telithromycin:no effect	[27]
Respiratory syncytial virus
RSV	Tahan et al. (2007)	Clarithromycin	15 mg/kg	Clinical trial	Cytokines (IL-4, IL-8, eotaxin, IFN-𝛾) duration of hospitalization, duration of need for supplemental oxygen, 𝛽2-agonist	Effective	[28]
RSV	Kneyber et al. (2008)	Azithromycin	10 mg/kg	Clinical trial	duration of hospitalization, duration of oxygen supplementation and nasogastric tube feeding, RSV symptom score, number of PICU referrals number of patients who received additional antibiotic treatment	No effect	[29]
RSV	Asada et al. (2009)	Bafilomycin A1 Clarithromycin	10 μM	In vitro (human tracheal epithelial cells)	Viral titers, cytokines (IL-1𝛽, IL-6, IL-8)	Inhibition	[30]
Influenza virus
A/Kumamoto/Y5/67	Sato et al. (1998)	Erythromycin	1.0 or 3.3 mg/kg	In vivo (Mice)	Survival rate, body weight, cytokines (IFN-𝛾, TNF-α, IL-1𝛽), NO2^−/NO3^−	Inhibition	[31]
A/PR/8/34 (H1N1)	Tsurita et al. (2001)	Clarithromycin	20 mg	In vivo (Mice)	Virus yield, severity of pneumonia, cytokines (IL-4, 6, 10, 12)	Inhibition IL-12: elevation	[32]
A/PR/8/34 (H1N1) A/Aichi/2/68 (H3N2); A/Memphis/1/71 (H3N2); A/WSN/33 (H1N1)	Miyamoto et al. (2008)	Clarithromycin	25 mg/mL	In vitro (MDCK cells, human lung epithelial A549 cells)	Multiple infection assay	Inhibition (middle to late stage of the viral replication cycle)	[20]
influenza A (H1N1) and (H3N2)	Sawabuchi et al. (2009)	Clarithromycin	5 mg/kg	Clinical trial	Antiviral sIgA, numbers of viral RNA copies, symptom	Inhibition	[33]
type A influenza virus (H3N2)	Yamaya et al. (2010)	Clarithromycin	10 μM	In vitro (human tracheal epithelial cells)	Viral titer, cytokines (IL-1𝛽, IL-6), viral RNA	Inhibition	[34]

RV: rhinovirus, IL: interleukin, ICAM-1: intercellular adhesion molecule-1, TNF-α: tumour necrosis factor alpha, Fn: fibronectin, CEACAM: carcinoembryonic antigen-related cell adhesion molecules, IFN: interferon, RSV: respiratory syncytial virus, and MDCK: Mardin-Darby canine kidney.