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Mediators of Inflammation
Volume 2012, Article ID 134605, 7 pages
http://dx.doi.org/10.1155/2012/134605
Review Article

The Role of Macrolides in Childhood Non-Cystic Fibrosis-Related Bronchiectasis

Paediatric Pulmonology Division, Department of Paediatrics and Child Health, Steve Biko Academic Hospital, University of Pretoria, Pretoria 0001, South Africa

Received 19 January 2012; Accepted 31 January 2012

Academic Editor: Kazuhito Asano

Copyright © 2012 R. Masekela and R. J. Green. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Non-cystic fibrosis-related bronchiectasis is a chronic inflammatory lung disease, which is regarded as an “orphan” lung disease, with little research devoted to the study of this condition. Bronchiectasis results in impaired quality of life and mortality if left untreated. The tools available in the armamentarium for the management of bronchiectasis entail antibiotic therapy traditionally used to treat exacerbations, stratagems to improve mucociliary clearance, and avoidance of toxins. Macrolides have been known for the last two decades to have not only anti-bacterial effects but immunomodulatory properties as well. In cystic fibrosis, the use of macrolides is well documented in subjects colonized with Pseudomonas aeruginosa, to improve quality of life and lung function. There is currently emerging evidence to suggest the benefit of macrolides in subjects not colonized with Pseudomonas aeruginosa. This beneficial effect has been less explored in the context of bronchiectasis from other causes. The purpose of this paper is to review the current literature on the use of macrolides in non-cystic fibrosis related bronchiectasis in paediatrics.