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Macrolide Use and Neutrophil Function/Cytokine Levels in Hospitalized Patients with Community-Acquired Pneumonia: A Pilot Study

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Abstract

Purpose

The objective of this study was to measure plasma cytokine levels and blood neutrophil functions as well as clinical outcomes in hospitalized patients with community-acquired pneumonia (CAP) treated with or without macrolide use—a known modulator of inflammatory response.

Methods

Subjects with CAP had peripheral blood analyzed for some neutrophil functions (degranulation of secretory vesicles and specific granules, respiratory burst response and phagocytosis) and ten cytokine levels measured in serum and sputum supernatants. Neutrophil function in healthy volunteers was also measured for reference. Values were measured on the day of enrollment, days 2–4 and 5–7, depending on a patient’s length of stay. Early and late clinical outcomes were also evaluated. All values were compared between those treated with or without a macrolide.

Results

A total of 40 subjects were in this study; 14 received macrolide treatment, and 26 did not. Neutrophil function in the macrolide group was not significantly different compared to the non-macrolide group. None of the median cytokine levels or IQRs were statistically significant between the groups. However, a trend toward decreased IL-6, IL-8, and IFN-γ levels, and favorable clinical outcomes were present in the macrolide group.

Conclusions

This pilot study showed no statistical difference between cytokine levels or neutrophil activity for CAP patients prescribed a macrolide containing regimen. Considering the trend of lower cytokine levels in the macrolide group when comparing the 5- to 7-day time period with the non-macrolide group, a full study with an appropriate sample size may be warranted.

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Acknowledgments

This material is based upon work approved by the University of Louisville Hospital and the Department of Veteran Affairs Offices of Research and Development, as well as the Veterans Health Administration. This work was unfunded.

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, 501 E. Broadway; Suite 140 B, Louisville, KY, 40202, USA

    Forest W. Arnold, Robert Kelley, Timothy L. Wiemken, Paula Peyrani & Julio A. Ramirez

  2. Section of Infectious Diseases, Providence Hospital, Washington, DC, USA

    Jose Bordon

  3. Department of Pathology and Laboratory Medicine, University of Louisville School of Medicine, Louisville, KY, USA

    Rafael Fernandez-Botran

  4. Division of Nephrology and Hypertension, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA

    Madhavi J. Rane & Silvia M. Uriarte

Authors
  1. Forest W. Arnold
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  2. Jose Bordon
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  3. Rafael Fernandez-Botran
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  4. Madhavi J. Rane
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  5. Silvia M. Uriarte
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  6. Robert Kelley
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  7. Timothy L. Wiemken
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  8. Paula Peyrani
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  9. Julio A. Ramirez
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for the Community-Acquired Pneumonia Inflammatory Study Group

Corresponding author

Correspondence to Forest W. Arnold.

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For the Community-Acquired Pneumonia Inflammatory Study Group.

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Arnold, F.W., Bordon, J., Fernandez-Botran, R. et al. Macrolide Use and Neutrophil Function/Cytokine Levels in Hospitalized Patients with Community-Acquired Pneumonia: A Pilot Study. Lung 194, 155–162 (2016). https://doi.org/10.1007/s00408-015-9822-7

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  • DOI: https://doi.org/10.1007/s00408-015-9822-7

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