1, Studies of macrolide immunomodulation for the treatment of chronic lung disease have shown consistent positive effects, but not in relation to diffuse panbronchiolitis. These effects, together with their inhibitory activity against biofilms, potentially make them a useful option. 2, The benefits of macrolides in combination with another atypical drug for CAP are consistent and greater than when another atypical drug is given alone, suggesting a non-antimicrobial effect. 3, Recent studies on the immunomodulatory properties of azithromycin suggest that azithromycin may have a previously unknown short-term biphasic effect on inflammation regulation: enhanced host defense mechanisms shortly after initial administration, followed by a reduction in local infection/inflammation. 4, Additional studies in vivo are needed to draw any firm conclusions.