The Efficacy And Safety Of Azithromycin Solution Aerosol Inhalation Treatment Research

PART 1 Effect of inhalating different concentration of azithromycin solution in airway of miceObjective:To evaluate the safety,feasibility and effectiveness of azithromycin nebulization in different concentration.Materials and Methods: Take 60 8-week-old BABL/c mices which were divided into 6 groups randomly and averagely including blank group,saline group,10mg/kg,20mg/kg,50mg/kg and 100mg/kg azithromycin group.These samples were respectively given nothing,inhaling normal saline or differently corresponding azithromycin concentration every morning for successive 5days by air compressed atomizer.During the process,Their common conditions(including mental state,diet,breathing and activity)were observed and recorded.5 days later,on one hand,the blood,bronchoalveolar lavage fluid(BALF)and lung tissue were acquired and the total protein and lactate dehydrogenase(LDH)activity in BALF and lung tissue HE dyeing pathological change were analyzed to assess azithromycin-local-treatment's safety and feasibility;on the other hand,by high performance liquid chromatography(HPLC),the concentrations of azithromycin in BALF and blood were tested.Azithromycin concentrations of lung epithelial mucus layer(lung epithelial mucus layer,the ELF)were calculated by urea dilution method to analyze the availability of the therapy.Result:First,there was no seriously untoward effect happening.Then,in biochemistry aspect,significant statistical difference was existed between the blank and the 100mg/kg group in BALF's total protein and LDH activity(P< 0.05),while no significant differences between the blank and the other groups;in pathology aspect,mass of neutrophils infiltrated around pulmonary mesenchyme and blood vessels with alveolar walls collapsed in 100 mg/kg group.However,lung tissue pathology in other groups showed no statistical difference with the blank group.Azithromycin concentration in ELF of different groups was far greater than it in corresponding blood,the drug concentration in ELF was higher than the MIC of mycoplasma pneumoniae and lung legionella bacteria.Conclusion: Nebulization in concentration of 10mg/kg to 50mg/kg azithromycin is safe,feasible and tolerant.Drug concentration of azithromycin in ELF is much higher than it in the blood.PART 2 Effect observation on low doses of azithromycin treatment for the community-acquired pneumonia in atomization curative1Objective:To observe the efficacy of the low doses of atomizing azithromycin for patients with community-acquired pneumonia in short period.Methods: 80 patients with community-acquired pneumonia,selected from department of respiration in our hospital between september 2014 and november 2016,were randomly divided into treatment group(inhaling 250 mg/d azithromycin + 5 ml0.9% saline)and the control group(inhaling 5 ml 0.9% saline).Two groups were both given anti-infection with cefotiam or cefuroxime cephalosporin,spasmolysis,expectorant treatment and so on.Observed the clinical efficacy,the hospital clinical observation index,clinical symptoms and signs(the time needed for antifebrile and chest radiographic lesions absorbion more than 50%,80%in two groups,score of sputum volume and character),the related inflammation indexes(WBC,NEUT,PCT,CRP,IL-6,IL-8,TNF-? and s TREM-1)and the side-effected reactions.Results:Two groups of efficient,length of hospital stay,the incidence of hospitalization expense,time for fantifebrile,related inflammation index,the change in volume and character of sputum and shadow absorption in chest radiograph was statistically difference(P<0.05).There was statistically significant difference between the treatment group and the control group in IL-6,IL-8,TNF-a,CRP and s TREM-1treatment(P < 0.01).Conclusions:There is antimicrobial action in the treatment for community-acquired pneumonia with low doses of inhaling azithromycin for short period which also clould increasing efficiency,reduce the length of hospital stay hospitalization expenses,improve the change in volume and character of sputum and shadow absorption in chest radiograph was statistically difference and will be a promising way of treatment.