title: Effects of azithromycin in Pseudomonas aeruginosa burn wound infection.
abstract: BACKGROUND
  Cutaneous thermal injuries (i.e., burns) remain a common form of debilitating trauma, and outcomes are often worsened by wound infection with environmental bacteria, chiefly Pseudomonas aeruginosa.
  
  
  METHODS
  We tested the effects of early administration of a single dose of azithromycin, with or without subsequent antipseudomonal antibiotics, in a mouse model of standardized thermal injury infected with P aeruginosa via both wound site and systemic infection. We also tested the antimicrobial effects of these antibiotics alone or combined in comparative biofilm and planktonic cultures in vitro.
  
  
  RESULTS
  In our model, early azithromycin administration significantly reduced wound and systemic infection without altering wound site or circulating neutrophil activity. The antimicrobial effect of azithromycin was additive with ciprofloxacin but significantly reduced the antimicrobial effect of tobramycin. This pattern was reproduced in biofilm cultures and not observed in planktonic cultures of P aeruginosa.
  
  
  CONCLUSIONS
  These data suggest that early administration of azithromycin following burn-related trauma and infection may reduce P aeruginosa infection and potential interactions with other antibiotics should be considered when designing future studies.
authors.affiliation: Pulmonary Medicine Division, Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA. nicholsd@njhealth.org
authors.forename: David P
authors.initials: DP
authors.lastname: Nichols
authors.forename: Silvia
authors.initials: S
authors.lastname: Caceres
authors.forename: Lindsay
authors.initials: L
authors.lastname: Caverly
authors.forename: Cori
authors.initials: C
authors.lastname: Fratelli
authors.forename: Sun Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: Ken
authors.initials: K
authors.lastname: Malcolm
authors.forename: Katie R
authors.initials: KR
authors.lastname: Poch
authors.forename: Milene
authors.initials: M
authors.lastname: Saavedra
authors.forename: George
authors.initials: G
authors.lastname: Solomon
authors.forename: Jennifer
authors.initials: J
authors.lastname: Taylor-Cousar
authors.forename: Samuel
authors.initials: S
authors.lastname: Moskowitz
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Nick
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D002056:Burns / Q000150:complications*; D002939:Ciprofloxacin / Q000627:therapeutic use; D004195:Disease Models, Animal; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D008297:Male; D051379:Mice; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa; D014031:Tobramycin / Q000627:therapeutic use; D016896:Treatment Outcome; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D017963:Azithromycin; D014031:Tobramycin
keywords: Azithromycin; Biofilm; Burn; Burn wound; Ciprofloxacin; Cystic fibrosis; Drug–drug interaction; Pseudomonas aeruginosa; Thermal injury; Tobramycin