Immunomodulatory effects of antimicrobials in the therapy of respiratory tract infections

Parnham, Michael J.

doi:10.1097/01.qco.0000160901.71813.fe

Cited by 97 publications

(73 citation statements)

References 50 publications

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“…In addition to their antibacterial activity, macrolides show a number of biological effects of great importance, including antibiofilm, anti-inflammatory and immunomodulatory activities. [46][47][48][49] An interesting outcome of the present study was the significant improvement in sexual function following antibacterial therapy. This is to our knowledge the first report providing the rate of erectile function improvement in CBP patients subjected to Figure 1 Urine peak flow rate (Q max ) (mean6s.d., ml s 21 ) in patients in the Cipro-750 (black bars) and Cipro-500 (grey bars) treatment groups.…”

Section: Discussionmentioning

confidence: 60%

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Magri¹,

Montanari²,

Škerk³

et al. 2011

Asian J Androl

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We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category II chronic bacterial prostatitis (CBP). The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin (500 mg, thrice-weekly) with a once-daily 500-or 750-mg dose of ciprofloxacin (Cipro-500 or Cipro-750 cohort, respectively). Combined administration of azithromycin (1500 mg week 21 ) with ciprofloxacin at the rate of 750 mg day 21 for 4 weeks rather than at 500 mg day 21 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen (PSA) were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction (ED) at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.

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Section: Discussionmentioning

confidence: 60%

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Magri¹,

Montanari²,

Škerk³

et al. 2011

Asian J Androl

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“…Anti-inflammatory effects (10,11), inhibitory effects on respiratory secretions (12) and modulation of bacterial functions (13) have been reported for macrolide antibiotics, in addition to their antibiotic effects, and the clinical effects of these drugs as immunomodulatory agents have been observed, especially in patients with DPB (14,15). In addition to anti-inflammatory effects, Sugiyama et al (16) reported that AZM and CAM may have had different pharmacological effects due to their different regulatory effects on cytokine production in pneumocyte-like cells.…”

Section: Discussionmentioning

confidence: 99%

A Case of Good Syndrome with Pulmonary Lesions Similar to Diffuse Panbronchiolitis

et al. 2012

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We herein present a case of Good syndrome complicated by diffuse pulmonary lesions similar to diffuse panbronchiolitis (DPB). A 45-year-old Japanese man was referred to our department due to recurrent lower respiratory tract infections that had started and ameliorated nine months after thymectomy for pure red cell aplasia and myasthenia gravis. Diffuse centrilobular opacities on chest computed tomography and positivity for HLA-B54 were consistent with DPB. Additionally, hypogammaglobulinemia and a marked decrease of Blymphocytes were observed, and therefore Good syndrome was considered. Combination therapy with azithromycin and clarithromycin alleviated the patient's respiratory symptoms and reduced the exacerbation of chronic bronchitis.

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“…This effect is independent of their antimicrobial activity and seems to be associated with the immunomodulatory effects on the cytokine response to macrolides. (36) This effect is the likely explanation for the improved survival found with macrolide combination therapy of bacteremic pneumococcal pneumonia. Biomarkers such as cytokines, CRP, procalcitonin, and cortisol identified as markers of host-response to sepsis might improve traditional scoring factors in predicting outcomes and guiding response to therapy, (37) but this approach has yet to be validated.…”

Section: Introductionmentioning

confidence: 99%

Entendendo o conceito PIRO: da teoria à prática clínica - Parte 1

Rabello¹,

Rosolem²,

Leal³

et al. 2009

Rev. bras. ter. intensiva

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Despite recent advances in diagnosis and care of critically ill patients sepsis related mortality rate remains unacceptably high. Therefore, new methods of evaluation are necessary to provide an earlier and more accurate characterization of septic patients. Based on the (oncologic) TNM system, the PIRO concept was introduced as a new staging system for sepsis in order to assess risk and predict prognosis, with potential to assist in inclusion of patients in clinical studies and estimate the probability of response of patients to specific therapeutic interventions.

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Immunomodulatory effects of antimicrobials in the therapy of respiratory tract infections

Cited by 97 publications

References 50 publications

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

A Case of Good Syndrome with Pulmonary Lesions Similar to Diffuse Panbronchiolitis

Entendendo o conceito PIRO: da teoria à prática clínica - Parte 1

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