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Respir Investig. 2014 Sep;52(5):302-9. doi: 10.1016/j.resinv.2014.05.001. Epub 2014 Jul 11.

Additional treatment with clarithromycin reduces fever duration in patients with influenza.

Author information

1
Higashi Clinic, 589-1 Higashi-Honjou, Minabe-Cho, Hidaka-Gun, Wakayama Prefecture 645-0021, Japan. Electronic address: higashiclinic@deluxe.ocn.ne.jp.
2
Department of Advanced Preventive Medicine for Infectious Disease, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. Electronic address: hkubo@med.tohoku.ac.jp.
3
Yaotome Ekimae Clinic of Internal Medicine and Pediatrics, 1-3-26 Yaotome-Chuo, Izumi-ku, Sendai 981-3135, Japan. Electronic address: hiroyasuyasuda@gmail.com.
4
South Miyagi Medical Center, 38-1 Aza-nishi, Ohgawara, Shibata-gun, Miyagi Prefecture 989-1253, Japan. Electronic address: toshinkw47@gmail.com.
5
Department of Advanced Preventive Medicine for Infectious Disease, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. Electronic address: myamaya@med.tohoku.ac.jp.

Abstract

BACKGROUND:

Influenza virus infection-induced inflammatory responses are associated with fever and other symptoms. Although macrolide antibiotics (macrolides) provide anti-inflammatory effects, these effects have not been well studied in influenza patients.

METHODS:

We examined the effects of clarithromycin on influenza symptoms. A randomized, prospective, and open-label study was performed between December 2010 and March 2011 and between December 2012 and March 2013 in patients with pandemic A/H1 2009 influenza or seasonal influenza virus infections. Patients aged >15 years received either neuraminidase inhibitors (control group) or clarithromycin plus neuraminidase inhibitors (clarithromycin group). Body temperature and other symptoms were recorded for 5 days after initiating treatment. Serum interleukin (IL)-6 and IL-8 levels were also measured.

RESULTS:

Herein, 79 patients were enrolled over the two influenza seasons, and data from 63 patients were analyzed. All patients showed fever and other symptoms, including rhinorrhea (n=38), cough (n=50), sore throat (n=39), arthralgia or myalgia (n=46), and general malaise (n=50). Fever duration was approximately 42% shorter in patients with temperatures ≥38.5°C (p=0.02), decreasing from 42 h to 24 h. Among patients with pandemic influenza infections (n=20), the rhinorrhea improvement rate was higher in the clarithromycin group (p=0.03; 88% vs. 20%). Serum IL-6 levels decreased 5 days after treatment, but no differences between the two groups were detected.

CONCLUSIONS:

Clarithromycin may have the additional clinical benefit of improving fever, the main symptom of influenza, in patients treated with neuraminidase inhibitors.

KEYWORDS:

Clarithromycin; Fever; Inflammation; Influenza; Neuraminidase inhibitor

PMID:
25169846
DOI:
10.1016/j.resinv.2014.05.001
[Indexed for MEDLINE]
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