title: Lung inflammatory pattern and antibiotic treatment in pneumonia.
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.
  
  
  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.
authors: María-José
authors: MJ
authors: Lorenzo
authors: Inés
authors: I
authors: Moret
authors: Benjamín
authors: B
authors: Sarria
authors: Enrique
authors: E
authors: Cases
authors: Julio
authors: J
authors: Cortijo
authors: Raúl
authors: R
authors: Méndez
authors: Jose
authors: J
authors: Molina
authors: Alejandra
authors: A
authors: Gimeno
authors: Rosario
authors: R
authors: Menéndez
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology / Q000382:microbiology; D001999:Bronchoscopy; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D016207:Cytokines / Q000097:blood*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007902:Length of Stay; D008137:Longitudinal Studies; D008168:Lung / Q000187:drug effects* / Q000276:immunology / Q000382:microbiology; D018942:Macrolides / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D011446:Prospective Studies; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators; D018942:Macrolides