Objective. The present study aims at reviewing the main publications on the use of
macrolides as
immunomodulators in patients with noncystic
fibrosis bronchiectasis. Source of Data. The Medline database was our source of data for this research carried out until June 2011, using the key words:
macrolides and
bronchiectasis, while searching for original articles and reviews. Summary of Data. Seven clinical studies that evaluated the action of the
macrolides in patients with
bronchiectasis were found. There was the sputum volume, reduction in pulmonary exacerbation frequency, and in the use of antimicrobial treatment, in addition to pulmonary function improvement. Conclusions. Anti-inflammatory action and immunomodulatory effects can be attributed to
macrolides when administered in low doses and on the long term. This use has been well established both in
diffuse panbronchiolitis and in
cystic fibrosis. Evidence indicates possible benefits in
bronchiectasis. Future studies are needed, though, to establish the ideal dose and
treatment duration and to understand the implications in the generation of microbial resistance."When patients have bacteria that are resistant to all
antibiotics, prescribe
erythromycin, leave them on it for a long time, and they will do much better"Dr. Harry Shwachman, 1950.