Document Detail


Azithromycin reduces gastroesophageal reflux and aspiration in lung transplant recipients.
MedLine Citation:
PMID:  19241165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Azithromycin (AZI) is a macrolide antibiotic that improves lung function in lung transplant recipients (LTx). Gastroesophageal reflux (GER) has been implicated in the pathogenesis of chronic rejection after LTx. Macrolide antibiotics may affect GER by modifying esophageal and gastric motility. The purpose of this study was to evaluate the effect of AZI on GER and gastric aspiration after LTx. Acid and weakly acidic GER was measured with 24-h pH-impedance monitoring in 47 LTx patients (12 patients "on" AZI). Gastric aspiration was assessed in a separate group of 30 LTx patients before and after AZI by measurements of pepsin and bile acid in bronchoalveolar lavage fluid (BALF). Patients "on" AZI had a significant lower total number of reflux events [41 (30-61) vs. 22.5 (7-37.5)], number of acid reflux events [24 (16-41) vs. 8 (4-18)], esophageal acid exposure [2.9% (0.7-7.3) vs. 0.2% (0.1-2.0)], bolus exposure [0.73% (0.5-1.4) vs. 0.21% (0.12-0.92)], and proximal extent of reflux [14 (9-24) vs. 5 (2-7)]. AZI reduced the concentration of bile acids in BALF without affecting levels of pepsin. LTx patients "on" AZI have less GER and bile acids aspiration. This effect might be due to enhanced esophageal motility and accelerated gastric emptying.
Authors:
V Mertens; K Blondeau; A Pauwels; R Farre; B Vanaudenaerde; R Vos; G Verleden; D E Van Raemdonck; L J Dupont; D Sifrim
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Publication Detail:
Type:  Journal Article     Date:  2009-02-25
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  54     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-03-31     Completed Date:  2009-04-17     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  972-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / therapeutic use*
Azithromycin / therapeutic use*
Bile Acids and Salts / analysis
Bronchoalveolar Lavage Fluid / chemistry
Cohort Studies
Cross-Sectional Studies
Esophageal pH Monitoring
Female
Gastroesophageal Reflux / etiology,  prevention & control*
Gastrointestinal Agents / therapeutic use*
Humans
Lung Transplantation / adverse effects*
Male
Middle Aged
Pepsin A / analysis
Respiratory Aspiration / etiology,  prevention & control*
Grant Support
ID/Acronym/Agency:
G0802313//Medical Research Council
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Bile Acids and Salts; 0/Gastrointestinal Agents; 83905-01-5/Azithromycin; EC 3.4.23.1/Pepsin A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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