Clarithromycin stops lung function decline in airway-centered interstitial fibrosis

• Published in: Respiration Vol. 85; no. 2; p. 156
• Main Authors: Jouneau, S, Kerjouan, M, Caulet-Maugendre, S, Guillot, S, Meunier, C, Desrues, B, Delaval, P
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2013
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Clarithromycin - therapeutic use; Enzyme Inhibitors; Esomeprazole - adverse effects; Glucocorticoids - adverse effects; Humans; Lung Diseases, Interstitial - diagnostic imaging; Lung Diseases, Interstitial - drug therapy; Male; Prednisolone - adverse effects; Pulmonary Fibrosis - drug therapy; Pulmonary Fibrosis - pathology; Radiography; Respiratory Function Tests; Treatment Failure
• ISSN: 1423-0356
• DOI: 10.1159/000341982

Airway-centered interstitial fibrosis (ACIF) is a distinct type of lung interstitial fibrosis characterized by lesions centered on the airways. Several cases reported in the literature showed little to no effect of corticosteroids and a high mortality rate in the absence of lung transplantation. No other efficient approach is described for the treatment of this type of fibrosis. We report for the first time the case of a 44-year-old patient diagnosed with ACIF on surgical lung biopsy and stabilized with clarithromycin after failure of systemic corticosteroids. We need to confirm this benefit in other patients to ascertain the anti-inflammatory effect of macrolides, which are far less harmful compared to corticosteroids or immunosuppressant drugs.