Side Effects of Low Dose and Long Term Erythromycin in Treatment of Sulfur Mustard-Induced Bronchiolitis Obliterans

Bronchiolitis Obliterans (BO) is known as a side effect of sulfur mustard (SM) exposure. Long term prescription of low dose macrolides has been found to be effective in BO. There is no report on the side effects of these drugs on sulfur mustard-induced BO. We compared the side effects of Erythromycin (EM), a member of macrolide family, with low-doses (400 mg daily) for 6 months versus placebo in treatment of BO induced by S M. This study was a double blind clinical trial carried out in Chemical Injuries Research Center of Baqyatallah (a.s.) University of Medical Science. 120 SM- induced BO patients were categorized randomly in group 1 (n=60, EM 400 mg daily) and group 2 (n=60, Placebo). Patients received EM or placebo during a 6-month period. Side effects such as headache, maculopapular rash, pharyngitis, nausea, diarrhea, abdominal pain, dizziness, vomiting, fever and icter were assessed and compared in both groups before and after treatment. The most common side effects in group 1 were pharyngitis (36.36%) and headache (36.36%), and in group 2 pharyngitis (37.50%) and maculopapular rash (37.50%). The prevalence of headache, abdominal pain, icter, dizziness, vomiting and diarrhea in group 1 was more than group 2 (p<0.05). According to the previous studies which demonstrated severity of side effects of EM resulted in decreasing use of it and its therapeutic outcomes, it is recommended to use other macrolides like clarythromycin and azythromycin in Bronchiolitis Obliterans due to sulfur mustard.