Azithromycin maintenance therapy in patients with cystic fibrosis: A dose advice based on a review of pharmacokinetics, efficacy, and side effects

Erik B. Wilms, Daniel J. Touw, Harry G.M. Heijerman, Cornelis K. Van Der Ent

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22 Citations (Scopus)

Abstract

Azithromycin maintenance therapy results in improvement of respiratory function in patients with cystic fibrosis (CF). In azithromycin maintenance therapy, several dosing schemes are applied. In this review, we combine current knowledge about azithromycin pharmacokinetics with the dosing schedules used in clinical trials in order to come to a dosing advise which could be generally applicable. We used data from a recently updated Cochrane meta analysis (2011), the reports of clinical trials and pharmacokinetic studies. Based on these data, it was concluded that a dose level of 22-30âmg/kg/week is the lowest dose level with proven efficacy. Due to the extended half-life in patients with CF, the weekly dose of azithromycin can be divided in one to seven dosing moments, depending on patient preference and gastro-intestinal tolerance. No important side effects or interactions with other CF-related drugs have been documented so far. Pediatr Pulmonol. 2012; 47:658-665. © 2011 Wiley Periodicals, Inc.
Original languageEnglish
Pages (from-to)658-665
Number of pages8
JournalPediatric Pulmonology
Volume47
Issue number7
DOIs
Publication statusPublished - Jul-2012

Keywords

  • azithromycin maintenance therapy
  • cystic fibrosis
  • dosing schedule
  • pediatric dosage, neonatal dosage
  • pharmacokinetics
  • atorvastatin
  • azithromycin
  • cyclosporin
  • desloratadine
  • dornase alfa
  • erythromycin
  • mevinolin
  • placebo
  • pravastatin
  • rosuvastatin
  • roxithromycin
  • tacrolimus
  • area under the curve
  • bronchus secretion
  • diarrhea
  • drug absorption
  • drug antagonism
  • drug bioavailability
  • drug blood level
  • drug clearance
  • drug distribution
  • drug dose regimen
  • drug efficacy
  • drug elimination
  • drug half life
  • drug potentiation
  • drug tolerance
  • human
  • lung disease
  • lung fibrosis
  • maintenance therapy
  • maximum plasma concentration
  • nausea
  • nonhuman
  • ototoxicity
  • priority journal
  • review
  • wheezing

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