Macrolides and community-acquired pneumonia: is quorum sensing the key?
Combination therapy with two antimicrobial agents is superior to monotherapy in severe community-acquired pneumonia, and recent data suggest that addition of a macrolide as the second antibiotic might be superior to other combinations. This observation requires confirmation in a randomised control trial, but this group of antibiotics have pleiotropic effects that extend beyond bacterial killing. Macrolides inhibit bacterial cell-to-cell communication or quorum sensing, which not only might be an important mechanism of action for these drugs in severe infections but may also provide a novel target for the development of new anti-infective drugs.
Wise
Matt P
MP
Adult Critical Care, University Hospital of Wales, Cardiff CF14 4XW, UK. mattwise@doctors.org.uk
Williams
David W
DW
Lewis
Michael A O
MA
Frost
Paul J
PJ
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D004359:Drug Therapy, Combination; D006801:Humans; D018942:Macrolides / Q000008:administration & dosage / Q000627:therapeutic use*; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D053038:Quorum Sensing / Q000187:drug effects*
D000900:Anti-Bacterial Agents; D018942:Macrolides