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Effect of clarithromycin in inflammatory markers of patients with ventilator-associated pneumonia and sepsis caused by Gram-negative bacteria: results from a randomized clinical study

, : Effect of clarithromycin in inflammatory markers of patients with ventilator-associated pneumonia and sepsis caused by Gram-negative bacteria: results from a randomized clinical study. Antimicrobial Agents and ChemoTherapy 56(7): 3819-3825

One recent, double-blind, randomized clinical trial with 2 patients showed that clarithromycin administered intravenously for 3 days in patients with ventilator-associated pneumonia (VAP) accelerated the resolution of pneumonia and decreased the risk of death from septic shock and multiple organ dysfunctions (MODS). The present study focused on the effect of clarithromycin on markers of inflammation in these patients. Blood was drawn immediately before the administration of the allocated treatment and on six consecutive days after the start of treatment. The concentrations of circulating markers were measured. Monocytes and neutrophils were isolated for immunophenotyping analysis and for cytokine stimulation. The ratio of serum interleukin-1 (IL-1) to serum tumor necrosis factor alpha (TNF-α) was decreased in the clarithromycin group compared with the results in the placebo group. Apoptosis of monocytes was significantly increased on day 4 in the clarithromycin group compared with the rate of apoptosis in the placebo group. On the same day, the expression of CD86 was increased and the ratio of soluble CD4 ligand (sCD4L) to CD86 in serum was unchanged. The release of TNF-α, IL-6, and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) by circulating monocytes after stimulation was greater in the clarithromycin group than in the placebo group. The expression of TREM-1 on monocytes was also increased in the former group. These effects were pronounced in patients with septic shock and MODS. These results suggest that the administration of clarithromycin restored the balance between proinflammatory versus anti-inflammatory mediators in patients with sepsis; this was accompanied by more efficient antigen presentation and increased apoptosis. These effects render new perspectives for the immunotherapy of sepsis.


PMID: 22564837

DOI: 10.1128/AAC.05798-11

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Breaker, L., C.; Broenkow, W., W.; Watson, W., E.; Jo, Y.-Heon, 2008: Tidal and nontidal oscillations in Elkhorn Slough, CA. Elkhorn Slough is a shallow, tidally forced estuary that is directly connected to Monterey Bay. It is ebb-dominated and, due to continued erosion, the tidal prism has tripled over the past 40 years. Water level measurements at four locations are u...

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Jordan, J., 1971: Structure of the voice organ and vocalization in chimpanzees. Folia Morphologica 30(3): 361-381

Robinson Paul T.; Elders Wilfred A., 1971: Late Cenozoic volcanism in the Imperial Valley, California. Pages 151-153 1971

Holfort, A.M.; Kyvsgaard, D.O.; Roed, P., 1994: Salmonella analysis by the ICD system. Dansk Veterinaertidsskrift 77(4): 141-145

Lopes, Jão.Sollari.; Abril-de-Abreu, R.; Oliveira, R.F., 2016: Brain Transcriptomic Response to Social Eavesdropping in Zebrafish (Danio rerio). Public information is widely available at low cost to animals living in social groups. For instance, bystanders may eavesdrop on signaling interactions between conspecifics and use it to adapt their subsequent behavior towards the observed individ...

Partosch, F.; Stahlmann, R., 2011: Hypertension in pregnancy. ACE inhibitors and angiotensin II receptor antagonists are contraindicated because of their potential fetotoxicity. Medizinische Monatsschrift für Pharmazeuten 34(10): 358-362

Takahashi, M., 1973: Methods of disinfection of hands of puerperal patients. Josanpu Zasshi 27(3): 36-38