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PANBRONCHIOLITIS - DIFFUSE

Diffuse panbronchiolitis is an inflammatory disease affecting the respiratory bronchioles.
It causes progressive suppurative and obstructive respiratory disease.
This is an idiopathic disease which is primarily found in Japan, Korea and China.
Predisposition to the disease may be genetically-related but environmental factors should also be considered.
Failure to treat diffuse panbronchiolitis can lead to development of bronchiectasis, progressive failure and death.

Panbronchiolitis%20-%20diffuse Treatment

Treatment

Pharmacotherapy

Macrolides should be started as soon as diagnosis is established

Macrolides

Eg Erythromycin,14 member-ringed macrolides (eg Clarithromycin, Roxithromycin), & the 15 member-ringed macrolide Azithromycin
Erythromycin is the 1st choice in treatment of diffuse panbronchiolitis (DPB)
- Treatment duration is for at least 6 months
Other macrolides (Clarithromycin, Roxithromycin, Azithromycin) are used when Erythromycin is ineffective or not tolerated
Studies show better lung function (decreased dyspnea, opacities in HRCT) w/ Azithromycin use in patients w/ DPB

Actions:

Inhibit production of pro-inflammatory cytokines & formation of leukotriene B4
Block the formation of adhesion molecules required for migration of neutrophils

Effects:

Decreased inflammation of the airways, leading to improved pulmonary function & decreased infection
Erythromycin helps improve host defense & regulate bacterial activities

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Pearl Toh, 21 Sep 2020

Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.

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Pearl Toh, 29 Jul 2021

While RT-PCR is the current gold standard to confirm a SARS-CoV-2 infection, antigen rapid test (ART) for COVID-19 allows for quick detection of SARS-CoV-2 and thus fast triaging of infected patients requiring isolation at the population level, according to studies presented at ECCMID 2021.

New asthma guide: What doctors should know

Pearl Toh, 26 Nov 2020

Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.