Update on the combination effect of macrolide antibiotics in community-acquired pneumonia

Mortality in patients with community‐onset pneumonia at low risk of drug‐resistant pathogens: Impact of β‐lactam plus macrolide combination therapy

“…The role of combination therapy with a macrolide has been evaluated in several studies including patients with CAP . Previous studies report that mortality was lower in patients with severe CAP who received non‐antipseudomonal β‐lactam plus macrolide combination therapy (BLM) than in those who received other regimens such as non‐antipseudomonal β‐lactam monotherapy (BL) .…”

Is β-Lactam Plus Macrolide More Effective than β-Lactam Plus Fluoroquinolone among Patients with Severe Community-Acquired Pneumonia?: a Systemic Review and Meta-Analysis

“…It is well known that macrolides have immunomodulatory effects on inflammatory and epithelial cells, which can lead to attenuation of inflammatory response (8). In addition, a retrospective observational cohort study reported that combined BL-F therapy as an empirical therapy for severe CAP was associated with increased 30-day mortality when compared with other guideline-concordant antimicrobial regimens (19).…”

“…First, macrolides provide broader antibacterial spectrum for CAP because macrolides are generally effective against the main atypical pathogens such as Mycoplasma pneumoniae and Legionella (24). Second, as described above, macrolides exert immunomodulatory effects on inflammatory and epithelial cells (8). Third, antimicrobial synergism is attained by addition of a macrolide to β-lactam.…”

“…However, a β-lactam-based combination therapy is preferred for patients with severe CAP (58). Additionally, recent pooled analyses showed that addition of macrolides, which has been often used to cover atypical pathogens of CAP, was associated with reduction of mortality (910).…”

Lead Discovery Strategies for Identification of Chlamydia pneumoniae Inhibitors

“…Acknowledging the complexity of disease processes and living organisms in general, a shift from a “single drug, single target” concept toward attempts to affect whole biological networks is been arising within biomolecular screening [66], and increased understanding on the pharmacology of classical antibiotics also implies that their in vivo efficacy does not rely only on limiting bacterial replication, but also on immunomodulatory and potentially other activities [67]. Combination treatments and multifaceted therapy approaches can thus be expected to increase their popularity within antibacterials and other therapy areas, and C. pneumoniae cannot be expected to be an exception to this phenomenon.…”