Could Azithromycin Be Part of Pseudomonas aeruginosa Acute Pneumonia Treatment?
Azithromycin (AZM) is a 15-membered-ring macrolide that presents a broad-spectrum antimicrobial activity against Gram-positive bacteria and atypical microorganisms but suffers from a poor diffusion across the outer-membrane of Gram-negative bacilli, including Pseudomonas aeruginosa (PA). However, AZ...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-03-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2021.642541/full |
| _version_ | 1811270921604825088 |
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| author | Anne-Gaëlle Leroy Anne-Gaëlle Leroy Jocelyne Caillon Jocelyne Caillon Nathalie Caroff Alexis Broquet Stéphane Corvec Stéphane Corvec Karim Asehnoune Karim Asehnoune Antoine Roquilly Antoine Roquilly Lise Crémet Lise Crémet |
| author_facet | Anne-Gaëlle Leroy Anne-Gaëlle Leroy Jocelyne Caillon Jocelyne Caillon Nathalie Caroff Alexis Broquet Stéphane Corvec Stéphane Corvec Karim Asehnoune Karim Asehnoune Antoine Roquilly Antoine Roquilly Lise Crémet Lise Crémet |
| author_sort | Anne-Gaëlle Leroy |
| collection | DOAJ |
| description | Azithromycin (AZM) is a 15-membered-ring macrolide that presents a broad-spectrum antimicrobial activity against Gram-positive bacteria and atypical microorganisms but suffers from a poor diffusion across the outer-membrane of Gram-negative bacilli, including Pseudomonas aeruginosa (PA). However, AZM has demonstrated clinical benefits in patients suffering from chronic PA respiratory infections, especially cystic fibrosis patients. Since the rise of multidrug-resistant PA has led to a growing need for new therapeutic options, this macrolide has been proposed as an adjunctive therapy. Clinical trials assessing AZM in PA acute pneumonia are scarce. However, a careful examination of the available literature provides good rationales for its use in that context. In fact, 14- and 15-membered-ring macrolides have demonstrated immunomodulatory and immunosuppressive effects that could be of major interest in the management of acute illness. Furthermore, growing evidence supports a downregulation of PA virulence dependent on direct interaction with the ribosomes, and based on the modulation of several key regulators from the Quorum Sensing network. First highlighted in vitro, these interesting properties of AZM have subsequently been confirmed in the animal models. In this review, we systematically analyzed the literature regarding AZM immunomodulatory and anti-PA effects. In vitro and in vivo studies, as well as clinical trials were reviewed, looking for rationales for AZM use in PA acute pneumonia. |
| first_indexed | 2024-04-12T22:10:41Z |
| format | Article |
| id | doaj.art-6f879e3c4e434915a7e4e2897b879343 |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-04-12T22:10:41Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Microbiology |
| spelling | doaj.art-6f879e3c4e434915a7e4e2897b8793432022-12-22T03:14:45ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2021-03-011210.3389/fmicb.2021.642541642541Could Azithromycin Be Part of Pseudomonas aeruginosa Acute Pneumonia Treatment?Anne-Gaëlle Leroy0Anne-Gaëlle Leroy1Jocelyne Caillon2Jocelyne Caillon3Nathalie Caroff4Alexis Broquet5Stéphane Corvec6Stéphane Corvec7Karim Asehnoune8Karim Asehnoune9Antoine Roquilly10Antoine Roquilly11Lise Crémet12Lise Crémet13Laboratoire EA 3826 “Thérapeutiques cliniques et expérimentales des infections”, IRS2-Nantes Biotech, Université de Nantes, Nantes, FranceCHU de Nantes, Service de Bactériologie-Hygiène hospitalière, Nantes Université, Nantes, FranceLaboratoire EA 3826 “Thérapeutiques cliniques et expérimentales des infections”, IRS2-Nantes Biotech, Université de Nantes, Nantes, FranceCHU de Nantes, Service de Bactériologie-Hygiène hospitalière, Nantes Université, Nantes, FranceLaboratoire EA 3826 “Thérapeutiques cliniques et expérimentales des infections”, IRS2-Nantes Biotech, Université de Nantes, Nantes, FranceLaboratoire EA 3826 “Thérapeutiques cliniques et expérimentales des infections”, IRS2-Nantes Biotech, Université de Nantes, Nantes, FranceCHU de Nantes, Service de Bactériologie-Hygiène hospitalière, Nantes Université, Nantes, FranceCRCINA, U1232, CHU Nantes, Nantes, FranceLaboratoire EA 3826 “Thérapeutiques cliniques et expérimentales des infections”, IRS2-Nantes Biotech, Université de Nantes, Nantes, FranceCHU de Nantes, Service Anesthésie Réanimation Chirurgicale, Nantes Université, Nantes, FranceLaboratoire EA 3826 “Thérapeutiques cliniques et expérimentales des infections”, IRS2-Nantes Biotech, Université de Nantes, Nantes, FranceCHU de Nantes, Service Anesthésie Réanimation Chirurgicale, Nantes Université, Nantes, FranceLaboratoire EA 3826 “Thérapeutiques cliniques et expérimentales des infections”, IRS2-Nantes Biotech, Université de Nantes, Nantes, FranceCHU de Nantes, Service de Bactériologie-Hygiène hospitalière, Nantes Université, Nantes, FranceAzithromycin (AZM) is a 15-membered-ring macrolide that presents a broad-spectrum antimicrobial activity against Gram-positive bacteria and atypical microorganisms but suffers from a poor diffusion across the outer-membrane of Gram-negative bacilli, including Pseudomonas aeruginosa (PA). However, AZM has demonstrated clinical benefits in patients suffering from chronic PA respiratory infections, especially cystic fibrosis patients. Since the rise of multidrug-resistant PA has led to a growing need for new therapeutic options, this macrolide has been proposed as an adjunctive therapy. Clinical trials assessing AZM in PA acute pneumonia are scarce. However, a careful examination of the available literature provides good rationales for its use in that context. In fact, 14- and 15-membered-ring macrolides have demonstrated immunomodulatory and immunosuppressive effects that could be of major interest in the management of acute illness. Furthermore, growing evidence supports a downregulation of PA virulence dependent on direct interaction with the ribosomes, and based on the modulation of several key regulators from the Quorum Sensing network. First highlighted in vitro, these interesting properties of AZM have subsequently been confirmed in the animal models. In this review, we systematically analyzed the literature regarding AZM immunomodulatory and anti-PA effects. In vitro and in vivo studies, as well as clinical trials were reviewed, looking for rationales for AZM use in PA acute pneumonia.https://www.frontiersin.org/articles/10.3389/fmicb.2021.642541/fullmacrolidePseudomonas aeruginosaadjunctive therapycritically ill patientsacute pulmonary infectionsimmunomodulation |
| spellingShingle | Anne-Gaëlle Leroy Anne-Gaëlle Leroy Jocelyne Caillon Jocelyne Caillon Nathalie Caroff Alexis Broquet Stéphane Corvec Stéphane Corvec Karim Asehnoune Karim Asehnoune Antoine Roquilly Antoine Roquilly Lise Crémet Lise Crémet Could Azithromycin Be Part of Pseudomonas aeruginosa Acute Pneumonia Treatment? Frontiers in Microbiology macrolide Pseudomonas aeruginosa adjunctive therapy critically ill patients acute pulmonary infections immunomodulation |
| title | Could Azithromycin Be Part of Pseudomonas aeruginosa Acute Pneumonia Treatment? |
| title_full | Could Azithromycin Be Part of Pseudomonas aeruginosa Acute Pneumonia Treatment? |
| title_fullStr | Could Azithromycin Be Part of Pseudomonas aeruginosa Acute Pneumonia Treatment? |
| title_full_unstemmed | Could Azithromycin Be Part of Pseudomonas aeruginosa Acute Pneumonia Treatment? |
| title_short | Could Azithromycin Be Part of Pseudomonas aeruginosa Acute Pneumonia Treatment? |
| title_sort | could azithromycin be part of pseudomonas aeruginosa acute pneumonia treatment |
| topic | macrolide Pseudomonas aeruginosa adjunctive therapy critically ill patients acute pulmonary infections immunomodulation |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2021.642541/full |
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