Maintenance azithromycin therapy for bronchiolitis obliterans syndrome: Results of a pilot study

Susan G. Gerhardt, John F. McDyer, Reda Girgis, John Vic Conte, Stephen C. Yang, Jonathan B. Orens

Research output: Contribution to journalArticlepeer-review

284 Scopus citations


Bronchiolitis obliterans syndrome remains the leading cause of morbidity and mortality in the pulmonary transplant population. Previous studies show that macrolide antibiotics may be efficacious in the treatment of panbronchiolitis and cystic fibrosis. In the latter, azithromycin decreases the number of respiratory exacerbations, improves FEV1, and improves quality of life. We hypothesized that oral azithromycin therapy may improve lung function in patients with bronchiolitis obliterans syndrome. To test this hypothesis, we conducted an open-label pilot trial using maintenance azithromycin therapy in six lung transplant recipients (250 mg orally three times per week for a mean of 13.7 weeks). In this study, five of these six individuals demonstrated significant improvement in pulmonary function, as assessed by FEV1, as compared with their baseline values at the start of azithromycin therapy. The mean increase in the percentage of predicted FEV1 values in these individuals was 17.1% (p ≤ 0.05). In addition, the absolute FEV1 increased by 0.50 L (range -0.18 to 1.36 L). These data suggest a potential role for maintenance macrolide therapy in the treatment of bronchiolitis obliterans syndrome in lung transplant recipients.

Original languageEnglish (US)
Pages (from-to)121-125
Number of pages5
JournalAmerican journal of respiratory and critical care medicine
Issue number1
StatePublished - Jul 1 2003


  • Chronic rejection
  • Lung transplant
  • Macrolides
  • Obliterative bronchiolitis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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