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Macrolide antibiotics and serum theophylline levels in relation to the severity of respiratory impairment: a comparison between the effects of erythromycin and josamycin.

Ten patients with exacerbated chronic asthmatic bronchitis, subdivided into two groups on the basis of respiratory failure, were treated with theophylline-ethylendiamine administered by continuous venous infusion (0.7 mg/kg/hr over a period of 132 hrs). The aim of the study was the evaluation of serum theophylline levels during administration of erythromycin or josamycin (500 mg q.i.d. orally for 48) hours). An increase of theophylline levels was registered during erythromycin treatment in the group of patients with greater impairment of the respiratory function, while in the other group no significant change was observed. During josamycin treatment serum theophylline concentrations did not show any increase in both groups and, moreover, a significant reduction (p less than 0.05) was observed in the more seriously ill patients.