What is the meaning of LTEM (Long-Term Erythromycin therapy Management)?

From the Guidelines

Long-Term Erythromycin therapy Management (LTEM) refers to the careful administration and monitoring of erythromycin, a type of macrolide antibiotic, over an extended period, typically in patients with respiratory diseases, with the primary goal of reducing morbidity, mortality, and improving quality of life. The management of LTEM involves several key steps, including optimizing non-pharmacological and pharmacological therapies prior to initiation, such as smoking cessation and optimized inhaler technique, as recommended by the British Thoracic Society guideline for the use of long-term macrolides in adults with respiratory disease 1. Some of the essential considerations in LTEM include:

• Performing an ECG prior to initiation to assess QTc interval, as a QTc interval >450 ms for men and >470 ms for women is considered a contraindication to initiating macrolide therapy 1
• Counseling patients about potential adverse effects, including gastrointestinal upset, hearing and balance disturbance, cardiac effects, and microbiological resistance 1
• Regular monitoring of liver function tests and ECGs to detect any potential side effects, with liver function tests checked 1 month after starting treatment and then every 6 months, and an ECG performed 1 month after starting treatment to check for new QTc prolongation 1
• Assessing the risk-benefit profile of continued therapy if significant side effects develop, and considering dose reduction or alternative treatments if necessary 1
• Regular follow-up at 6 and 12 months to determine whether benefit is being derived from therapy, using objective measures such as exacerbation rate, CAT score, or Quality of Life as measured by a validated assessment tool such as SGRQ, and stopping treatment if no benefit is observed 1.

From the Research

Definition of LTEM

There are no research papers to assist in answering this question, as none of the provided studies mention LTEM (Long-Term Erythromycin therapy Management).

Related Concepts

• The studies provided discuss various topics such as mold exposure, allergy, and antihistamine therapy, but do not mention LTEM specifically.
• Some studies discuss the treatment of allergic rhinitis and the use of antihistamines like loratadine 2, 3.
• Other studies examine the effects of mold exposure on human health and the diagnosis of related conditions 4, 5.
• The concept of differential diagnosis is also discussed in one of the studies 6.

Key Findings

• None of the studies provide information on LTEM, and therefore, no key findings can be reported on this topic.
• The studies do provide information on other topics, such as the effects of mold exposure 4, 5, the use of antihistamines like loratadine 2, 3, and the concept of differential diagnosis 6.