Clarithromycin in The Treatment of RSV Bronchiolitis: A Double-Blind, Randomized, Placebo-Controlled Trial

Respiratory syncytial virus bronchiolitis is the most common lower respiratory tract infection in infancy. There is no effective therapy for RSV bronchiolitis. To investigate the efficacy of clarithromycin in the treatment of RSV bronchiolitis, we conducted a randomized, double-blind, placebo controlled trial comparing clarithromycin with placebo in 21 infants with a diagnosis of RSV bronchiolitis. The infants were . Published on October 18, 2006 as doi: 10.1183/09031936.00029206 ERJ Express Copyright 2006 by the European Respiratory Society. randomized to receive clarithromycin daily for 3 weeks or placebo. Levels of IL-4, IL-8, eotaxin, and IFN-gamma were determined in plasma before, and after treatment using ELISA. Six months following treatment, parents were surveyed as to whether or not their child had had wheezing within the previous 6 months. Treatment with clarithromycin was associated with a statistically significant reduction in length of hospital stay , duration of need for supplemental oxygen and need for beta-2 agonist treatment. There were significant decreases in plasma IL-4, IL-8 and eotaxin levels after 3 weeks of treatment with clarithromycin. Readmission to the hospital within six months after discharge was significantly lower in the clarithromycin group. Clarithromycin had statistical significant effects on the clinical and laboratory findings in RSV bronchiolitis. Clarithromycin treatment may be helpful in reducing the shortterm effects of RSV bronchiolitis.