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Open Access 01-12-2015 | Research

Lung inflammatory pattern and antibiotic treatment in pneumonia

Authors: María-José Lorenzo, Inés Moret, Benjamín Sarria, Enrique Cases, Julio Cortijo, Raúl Méndez, Jose Molina, Alejandra Gimeno, Rosario Menéndez

Published in: Respiratory Research | Issue 1/2015

Abstract

Background

In community-acquired pneumonia host inflammatory response against the causative microorganism is necessary for infection resolution. However an excessive response can have deleterious effects. In addition to antimicrobial effects, macrolide antibiotics are known to possess immunomodulatory properties.

We aimed to evaluate inflammatory cytokine profiles – both locally (bronchoalveolar lavage) and systemically (blood) – in community-acquired pneumonia admitted patients after at least 72 hours of antibiotic treatment (with and without macrolide containing regimens) and requiring bronchoscopic examination for inadequate response due to infection progression and/or lack of clinical stability.

Methods

A prospective study was performed on 52 admitted patients who developed an inadequate response after 72 hours of antibiotic treatment - non-responders community-acquired pneumonia - (blood and bronchoalveolar lavage), and two control groups: 1) community-acquired pneumonia control (blood) and 2) non-infection control (blood and bronchoalveolar lavage). Cytokine profiles (interleukin (IL)-6, IL-8, IL-10), tumour necrosis factor α and clinical outcomes were assessed.

Results

Non–responders patients treated with macrolide containing regimens showed significantly lower levels of IL-6 and TNF-α in bronchoalveolar lavage fluid and lower IL-8 and IL-10 in blood than those patients treated with non-macrolide regimens. Clinical outcomes showed that patients treated with macrolide regimens required fewer days to reach clinical stability (p < 0.01) and shorter hospitalization periods (p < 0.01).

Conclusions

After 72 hours of antibiotic effect, patients who received macrolide containing regimens exhibited lower inflammatory cytokine levels in pulmonary and systemic compartments along with faster stabilization of infectious parameters.

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Title: Lung inflammatory pattern and antibiotic treatment in pneumonia
Authors: María-José Lorenzo
Inés Moret
Benjamín Sarria
Enrique Cases
Julio Cortijo
Raúl Méndez
Jose Molina
Alejandra Gimeno
Rosario Menéndez
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Respiratory Research / Issue 1/2015
Electronic ISSN: 1465-993X
DOI: https://doi.org/10.1186/s12931-015-0165-y

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