Effect of miocamycin and amoxicillin/clavulanate on total serum immunoglobulin E levels in patients with infectious exacerbations of allergic asthma: A crossover trial

Abstract In an open, randomized, crossover trial, the clinical efficacy and effect on total serum immunoglobulin E (IgE) levels of a macrolide—miocamycin—and of a beta-lactam—amoxicillin/clavulanate—were compared in patients with infectious exacerbations of bronchial asthma. Of the 42 patients admitted, 33 were evaluated for efficacy and tolerability of the treatments and 16 for the effect on serum IgE levels. Both treatments were effective in treating infectious exacerbations. Mild side effects (gastralgia) occurred in 19% of the miocamycin-treated patients, compared with 32% (generally, worsening of the asthma attacks) in the amoxicillin/clavulanate-treated patients. Total IgE serum levels were not affected by miocamycin, whereas they increased after treatment with amoxicillin/clavulanate (statistically significant difference). It would thus appear reasonable to prefer macrolides to beta-lactams in the treatment of asthmatic patients (at least as far as the tested drugs are concerned).