JMedCBRDef, Vol 3, 2005 www.jmedcbr.org 1 Journal of Medical Chemical, Biological and Radiological Defense IMPROVEMENT OF RESPIRATORY SYMPTOMS BY LONG-TERM LOW-DOSE ERYTHROMYCIN IN SULFUR MUSTARD EXPOSED CASES: A PILOT STUDY Mostafa Ghanei, Mehdi Ghasem zadeh, Majid Shohrati Research Center of Chemical Injuries, Baqiyatallah Medical Sciences University, Tehran, Iran Correspondence should be addressed to: Mostafa Ghanei, MD Professor of medicine- Pulmonologist Baqiyatallah Medical Sciences University Research Center of Chemical Injuries Mollasadra Street Tehran, Iran P.O. Box: 19945-546 Phone: +98 (21) 8053770 Fax: +98 (21) 8040106 Email : m.ghanei@bmsu.ac.ir ABSTRACT Background: Patients with chronic pulmonary complications due to sulfur mustard (SM) exposure suffer from symptoms such as chest pain, cough, sputum production, hemoptysis and dyspnea. Erythromycin (EM) has been found to be effective in some chronic inflammatory lung diseases such as diffuse panbronchiolitis (DPB), bronchiectasis and chronic obstructive pulmonary disease (COPD). This study evaluates its efficacy in symptomatic improvement of SM exposed patients. Methods: Low-dose EM (400-600 mg/day) has been administered in 43 patients with documented history of SM exposure for 6 months. All the patients were refractory to the bronchodilators and corticosteroids. Dyspnea, sleep disturbance, cough and hemoptysis were evaluated by a questionnaire at the beginning and at the end of the study period. Results: The intensity and frequency of dyspnea, sleep disturbance due to dyspnea, cough and hemoptysis were all reduced significantly after the treatment (p<0.05). Conclusion: The results of this preliminary study show that low- dose EM may improve respiratory symptoms in SM injured patients, and randomized double-blinded, placebo- controlled clinical trials are indicated to prove it. Given the suggestive diagnosis of Bronchiolitis Obliterans (BO) in SM exposed patients, the results imply that EM might be helpful in management of BO. KEYWORDS Sulfur mustard, respiratory symptoms, erythromycin