Treatment with protein synthesis inhibitors improves outcomes of secondary bacterial pneumonia after influenza

Åsa Karlström, Kelli L. Boyd, B. Keith English, Jonathan Mccullers

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Pneumonia occurring as a secondary infection after influenza is a major cause of excess morbidity and mortality, despite the availability and use of antibiotics active against Streptococcus pneumoniae. We hypothesized that the use of a bacteriostatic protein synthesis inhibitor would improve outcomes by reducing the inflammatory response. BALB/cJ mice infected with influenza virus and superinfected with S. pneumoniae were treated with either the cell-wall-active antibiotic ampicillin or the protein synthesis inhibitor clindamycin or azithromycin. In the model, ampicillin therapy performed significantly worse (survival rate, 56%) than (1) clindamycin therapy used either alone (82%) or in combination with ampicillin (80%) and (2) azithromycin (92%). Improved survival appeared to be mediated by decreased inflammation manifested as lower levels of inflammatory cells and proinflammatory cytokines in the lungs and by observation of less-severe histopathologic findings. These data suggest that β-lactam therapy may not be optimal as a first-line treatment for community-acquired pneumonia when it follows influenza.

Original languageEnglish (US)
Pages (from-to)311-319
Number of pages9
JournalJournal of Infectious Diseases
Volume199
Issue number3
DOIs
StatePublished - Feb 1 2009
Externally publishedYes

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Bacterial Pneumonia
Protein Synthesis Inhibitors
Ampicillin
Human Influenza
Azithromycin
Clindamycin
Streptococcus pneumoniae
Pneumonia
Anti-Bacterial Agents
Lactams
Orthomyxoviridae
Coinfection
Cell Wall
Therapeutics
Survival Rate
Observation
Cytokines
Inflammation
Morbidity
Lung

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Treatment with protein synthesis inhibitors improves outcomes of secondary bacterial pneumonia after influenza. / Karlström, Åsa; Boyd, Kelli L.; English, B. Keith; Mccullers, Jonathan.

In: Journal of Infectious Diseases, Vol. 199, No. 3, 01.02.2009, p. 311-319.

Research output: Contribution to journalArticle

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