zithromax and Pancreatitis

Topics: Acute Disease; Aged; Anti-Bacterial Agents; Azithromycin; Betacoronavirus; Coronavirus Infections; COVID-19; Female; Humans; Pancreatitis; Pandemics; Pneumonia, Viral; SARS-CoV-2; Sinusitis

Acute pancreatitis is a severe systemic disease triggered by a sterile inflammation and initial local tissue damage of the pancreas. Immune cells infiltrating into the pancreas are main mediators of acute pancreatitis pathogenesis. In addition to their antimicrobial potency, macrolides possess anti-inflammatory and immunomodulatory properties which are routinely used in patients with chronic airway infections and might also beneficial in the treatment of acute lung injury. We here tested the hypothesis that the macrolide antibiotic azithromycin can improve the course of acute experimental pancreatitis via ameliorating the damage imposed by sterile inflammation, and could be used as a disease specific therapy. However, our data show that azithromycin does not have influence on caerulein induced acute pancreatitis in terms of reduction of organ damage, and disease severity. Furthermore Infiltration of immune cells into the pancreas or the lungs was not attenuated by azithromycin as compared to controls or ampicillin treated animals with acute experimental pancreatitis. We conclude that in the chosen model, azithromycin does not have any beneficial effects and that its immunomodulatory properties cannot be used to decrease disease severity in the model of caerulein-induced pancreatitis in mice.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Ceruletide; Disease Models, Animal; Female; Lung; Mice; Pancreas; Pancreatitis; Severity of Illness Index; Treatment Outcome

Acute pancreatitis is an important cause of morbidity and mortality, mainly due to sepsis. The aim of this study was to determine the incidence of infectious complications and their impact on mortality in patients hospitalized for acute pancreatitis.. Patients admitted for acute pancreatitis were retrospectively included within a period between 1995 and 2000. Incidence of abdominal and extra-abdominal sepsis and specific care were specifically analyzed. Risk factors for death were evaluated by uni- and multivariated analysis.. Two hundreds and twelve consecutive patients (128 males, median age 54 years) were included. Mortality was 10.8%. At least one infectious episode was collected in 25% of the patients with an abdominal sepsis (26.8%), bacteriemia (24.4%), respiratory (24.4%) and urinary tracts (19.5%) infections. Infection was polymicrobial in 37.5%. An antibiotic prophylaxis was administered in 10.8%, more often in patients with severe pancreatitis. It did not alter mortality or incidence of infections but significantly delayed occurrence of sepsis. Mortality of patients treated with more than one line of antibiotics was higher. However in this study infectious complications were not an independent factor for mortality.. Infections are frequent and polymicrobial but are not an independent prognostic factor during acute pancreatitis.

Topics: Acute Disease; Adult; Age Factors; Aged; Aged, 80 and over; Amoxicillin; Anti-Bacterial Agents; Antibiotic Prophylaxis; APACHE; Azithromycin; Bacterial Infections; Ceftriaxone; Data Interpretation, Statistical; Drug Therapy, Combination; Female; Humans; Incidence; Male; Middle Aged; Pancreatitis; Prognosis; Retrospective Studies; Risk Factors; Sepsis; Time Factors