PCR studies have shown Mycoplasma pneumoniae and Chlamydophila pneumoniae in the lower airways of patients with asthma.92 adults with an Asthma Control Questionnaire score greater than 1.5 after a 4-week period of treatment with fluticasone propionate were enrolled in this study from National Jewish Health in Denver, Colorado.
13% demonstrated PCR evidence of M pneumoniae or C pneumoniae in endobronchial biopsies.
Clarithromycin did not improve lung function or airway inflammation. There was some improvement in airway hyperresponsiveness with clarithromycin.
Adding clarithromycin to fluticasone in adults with mild-to-moderate persistent asthma that was suboptimally controlled by low-dose inhaled corticosteroids alone did not further improve asthma control.
This study found a positive effect in children: Clarithromycin for 3 weeks was effective as add-on treatment of acute asthma exacerbations in children http://goo.gl/OeIPs
A 2012 retrospective study, suggested that neomacrolides may be useful as an add-on therapy in patients with severe asthma (Medscape, 2012).
References:
A trial of clarithromycin for the treatment of suboptimally controlled asthma. J Allergy Clin Immunol. 2010 Oct;126(4):747-53.
Image source: Clarithromycin structure, Wikipedia, public domain.