Efek Antiinflamasi Makrolid pada Pasien Bronkiektasis

William

doi:10.36452/jkdoktmeditek.v28i2.2355

Authors

William Departemen Farmakologi, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Krida Wacana, Jakarta, Indonesia

DOI:

https://doi.org/10.36452/jkdoktmeditek.v28i2.2355

Keywords:

bronkiektasis, eksaserbasi, inflamasi, makrolid

Abstract

Bronkiektasis merupakan penyakit inflamasi kronik di saluran napas berupa dilatasi menetap dari bronkus. Penyebab bronkiektasis adalah idiopatik (> 60%) dan didapat (< 40%). Bronkiektasis memiliki gejala klinis batuk berdahak kronik disertai sesak napas progresif. Kebanyakan pasien bronkiektasis memiliki kejadian eksaserbasi yang sering. Keadaan eksaserbasi yang semakin sering akan menyebabkan penurunan kualitas hidup, memperburuk gejala bronkiektasis, penurunan fungsi paru, dan meningkatkan mortalitas. Perubahan pada mekanisme pertahanan di paru dan proses inflamasi yang terus menerus akan mempermudah infeksi di bronkus. Oleh karena itu, pengobatan bronkiektasis ditujukan untuk memperbaiki sistem pertahanan paru dan mengurangi inflamasi yang terjadi. Makrolid merupakan antibiotik yang diduga memiliki aktivitas sebagai antiinflamasi sehingga dapat digunakan untuk pasien bronkiektasis. Beberapa penelitian randomized controlled trial (RCT) telah membuktikan bahwa penggunaan makrolid jangka panjang dapat mengurangi gejala eksaserbasi, memperbaiki fungsi paru, dan mengurangi produksi sputum 24 jam, tetapi meningkatkan resistensi terhadap kuman patogen penyebab infeksi pada bronkiektasis. Penggunaan makrolid jangka panjang sebaiknya mempertimbangkan keuntungan dan risiko seperti efek samping obat, interaksi obat, dosis obat, lama pengobatan, dan risiko munculnya resistensi.

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