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200( 96 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 Apr. 585 1 17 MIC 1. (Transtracheal aspiration: TTA) TTA TTA TTA 1400 TTA (diffuse panbronchiolitis, DPB) 1) erythromycin(em) EM 12.5% 87.5% 2,3) EM EM EM elastase 4,5) 6,7) 8) MIC 2. EM EM 3 20 23 87 12 8 DPB15 (bronchiectasis; BE) 4 (chronic bronchitis; CB) 1 EM TTA 8 8 EM 600 1200mg EM 28.9 1 20 EM

Apr. THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 201( 97 ) 1 EM 2 CAM EM 1 PaO 2 EM PaO 2 EM 66.6 7.0Torr 79.7 9.7Torr 3 PaO 2 3 14 2 1 85% 1 12.5% 87.5% 1 EM EM (CAM) 9,10) EM 13 DPB 6 BE 5 CB 2 CAM CAM 1 400 mg 3.8 EM CAM PaO 2 CAM PaO 2 CAM 1 2 13 7 X 4 2 EM CAM CAM CAM 250 mg 2 11) 3. EM EM 3 EM EM 2 EM

202( 98 ) THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 Apr. 2 CAM 3 EM EM EM 9 DPB 3 EM EM X

Apr. THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 203( 99 ) EM EM EM 3 6 16 18 8 8 52.3 DPB 9 BE 5 CB 2 EM 12 CAM 4 2.8 18 EM (CLDM) (MINO) 12 67% b - (ABPC) 2 (CEZ) (IPM/CS) 3 MIC 4 (PRSP) b - 3 4 mefa MIC 0.5 4 mg/ml ermb MIC 64 mg/ml CAM 50 100 m g/ml mefa EM 600 mg 22 CAM 400 mg

204(100) THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 Apr. 29 EM 600 mg 43 CAM 400 mg 29 EM EM mefa 43 25 CAM 29 2 7% ermb 4 12) EM mefa/ermb CAM mefa 4 MIC 4. EM EM NK biological response modifier BRM 5 EM 13) 5 1 QOL 5

Apr. THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 205(101) 5 (EAC) P388 6 CAM 6 CAM BRM 14,15) CAM CAM 6 CAM CAM 6 CAM 16 21) IL-6, TNF-a CAM 3 IL-6 CAM IL-6, TNF-a 7, 8 IL-12, IFN-g CAM 3 9 NK CAM 10, 11 CAM 6 12 3 10 4 CAM10 mg/kg/day 14

206(102) THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 Apr. 7 CAM IL-6 10 CAM NK 8 CAM TNF-a 11 CAM NK 9 CAM 12 CAM IL-6, IL-10, IL-12, IFN-g mrna RT-PCR ELISA 13, 14, 15 CAM 16 1 17 CAM Th2 Th1, 2 Th1 QOL CAM QOL

Apr. THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 207(103) 13 CAM IL-6, IL-10 mrna 16 CAM 14 CAM IL-12, IFN-g mrna 17 CAM integrin TGF-b RNA 15 CAM IFN-g QOL 5. 1)

208(104) THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 Apr. (TTA) 59: 389 395, 1985 2) Erythromycin Amoxicillin 60: 37 44, 1986 3) Erythromycin 3 66: 561 567, 1992 4) Erythromycin Pseudomonas aeruginosa Elastase 63: 1212 1214, 1986 5) KITA, E.; M. SAWAKI, D. OKU, A. HAMURO, K. MIKASA, M. KONISHI, M. EMOTO, S. TAKEUCHI, N. NARITA & S. KASHIBA: Supppression of virulence factors of Pseudomonas aeruginosa by erythromycin. J. Antimiorob. Chemother. 27: 273 284, 1991 6) Natural killer 63: 811 815. 1989 7) KITA, E.; M. SAWAKI, F. NISHIKAWA, K. MIKASA, Y. YAGYU, S. TAKEUCHI, K. YASUI, N. NARITA & S. KASHIBA: Enhanced interleukin production after long term administration of erythromycin stearate. Pharmacology 41: 177 183, 1990 8) 88: 1533 1540, 1999 9) Erythromycin(EM) 4 EM Clarithromycin 66: 1097 1104, 1992 10) Erythromycin clarithromycin 43: 430 435, 1994 11) KASAHARA, K.; K. MAEDA, K. MIKASA, K. UNO, K. TAKAHASHI, M. KONISHI, E. YOSHIMOTO, K. MURAKAWA, E. KITA & H, KIMURA: Longterm azithromycin therapy for three patient with chronic lower respiratory tract infections. J. Infection Chemother. 10: 42 45, 2004 12) KASAHARA, K.; E. KITA, K. MAEDA, K. MIKASA, K. UNO, K. TAKAHASHI, M. KONISHI, E. YOSHIMOTO, K. MURAKAWA & H. KIMURA: Macrolaid resistance of Streptococcus pneumoniae isolated during long term macrolide therapy: A difference between erythromycin and clarithromycin. J Infection Chemother., in press 13) HAMADA, K.; E. KITA, M. SAWAKI, K. MIKASA & N. NARITA: Antitumor effect of erythromycin. Experimental Chemotherapy 41: 59 69, 1995 14) clarithromycin biological response modifier 42: 1293 1298, 1994 15) MIKASA, K.; M. SAWAKI, E. KITA, K. HAMADA, S. TERAMOTO, M. SAKAMOTO, K. MAEDA, M. KONISHI & N. NARITA: Significant survival benefit to patients with advanced non-small-cell lung cancer from treatment with clarithromycin. Chemotherapy 43: 288 296, 1997 16) clarithromycin 44: 879 882, 1996 17) clarithromycin(cam) IL-6 44: 87 89, 1998 18) mrna clarithromycin 47: 345 348, 1999 19) clarithromycin NK 25: 2259 2266, 1998 20) Jpn. J. Antibiotics 48 (Suppl. A): 45 46, 1995 21) SAKAMOTO, M.; K. MIKASA, T. MAJIMA, K. NAMADA, M. KONISHI, K. MAEDA, E. KITA & N. NARITA: Anti-cachetic effect of clarithromyicin for patient with unresectable non-small cell lung cancer. Chemotherapy 47: 444 451, 2001

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