Abstract
BACKGROUND: Azithromycin, a macrolide antibiotic with notable anti-inflammatory properties, is widely used in the treatment of bronchiectasis. This study aimed to assess changes in serum fractional exhaled nitric oxide (FeNO), immunoglobulin E (IgE), and eosinophils levels before and after azithromycin treatment in bronchiectasis patients. METHODS: A retrospective cohort study was conducted at Rasul Akram Hospital involving bronchiectasis patients. Participants were evaluated in two phases: before receiving azithromycin (500 mg on every other day) and three months following oral azithromycin treatment. Demographic data, medical history, and baseline FeNO, IgE, and eosinophil levels were collected during the initial visit. These biomarkers were measured again at the follow-up visit. RESULTS: The study included 50 participants, with a mean (±SD) age of 40.78 (±5.45) years; 48% were females, and 52% were males. FeNO levels showed a significant decrease from 47.64±16.20 ppb at baseline to 18.6 ±5.99 ppb post-treatment (p<0.001). IgE levels also declined significantly from 747.90±166.87 IU/mL initially to 280.40±115.93 IU/mL (p<0.001). Additionally, eosinophil counts decreased from an initial mean of 687.00±199.18 cells/µL to 236.30±203.17 cells/µL at post-treatment (p<0.001). Patients with mild and moderate bronchiectasis exhibited significant reductions in inflammatory markers (p<0.001), those with more severe bronchiectasis did not show a comparable level of improvement. Gender and smoking status had no significant impact on treatment outcomes. CONCLUSION: Azithromycin administration significantly improved IgE, FeNO, and eosinophil serum levels, underscoring its therapeutic potential in modifying bronchiectasis-related inflammation.