[Macrolides. Antiinflammatory and immunomodulator effects. Indication in respiratory diseases].

This article reviews the basics and the clinical implications of the immunomodulatory effects of macrolides in different respiratory diseases. In addition to their antiinfective properties, some macrolides possess immunomodulatory effects (14 member ring). These macrolides have been used successfully to treat diffuse panbronchiolitis, a progressive inflamatory disease and may be very useful in the treatment of asthma, chronic bronchitis, chronic sinusitis, nasal polyps, otitis media with effusion, cystic fibrosis and bronchiectasis. We present the basic and clinical work supporting its chronic use. We will need future double blind controlled trials to determine the long term efficacy of macrolides for the treatment of chronic inflammatory airway diseases, as well as development of resistance, how to improve side effects ratio and the duration of effects after cessation of treatment.