Erdosteine is a multimechanism,
mucolytic agent that decreases the sputum viscoelastic properties and bacterial adhesion to the cell membrane, endowed with bronchial anti-inflammatory activity and a scavenging effect on free
oxidant radicals.
Erdosteine is a
prodrug and metabolite I is the active metabolite of
erdosteine owing to its free
thiol group. In acute infective exacerbation of
chronic bronchitis or
chronic obstructive pulmonary disease (
COPD), adding
erdosteine to standard treatment significantly modified the outcome by improving the symptoms and reducing the length of disease. Furthermore,
erdosteine has shown a synergism with
antibiotic therapy. In stable
COPD patients, long-term treatment with
erdosteine had a protective effect against exacerbations by reducing the rate of exacerbations and hospitalizations in the study period. A total of 8 months of treatment with
erdosteine significantly improved the patients' health status and preserved lung function.
Erdosteine has a scavenging effect on free
oxidant radicals by a direct and indirect antioxidative effect and the final result is a protective effect against tissue damage, as demonstrated in animal studies. In view of the persuasive evidence that oxidative stress is important in the pathophysiology of
COPD,
erdosteine appears to be a logical approach to
therapy.