Effect of Multiple Doses of Clarithromycin and Amoxicillin on IL-6, IFNγ and IL-10 Plasma Levels in Patients with Community Acquired Pneumonia

Abstract

Inflammation is crucial for the pathogenesis of both infectious and chronic obstructive pulmonary diseases. It is therefore important to modulate pulmonary inflammation in patients with these lung disorders. Macrolide antibiotics modulate inflammation in vitro and in in vivo by inhibiting the production of proinflammatory cytokines and prostaglandin E₂, neutrophil chemotactic activity and elastase activity.

This study evaluates the effect of clarithromycin (500 mg b.i.d. x 7 days) in comparison to amoxicillin (1 g t.i.d. x 7 days) in patients with community acquired pneumonia by testing plasma levels of IL-6, IFNγ and IL-10 before starting therapy and at the 3^rd and 7^th days of therapy. Clarithromycin significantly decreased plasma levels of IL-6 and significantly increased those of IFNγ and IL-10 at the 3^rd and 7^th day in comparison to basal levels. In patients treated with amoxicillin a significant decrease in IL-6 plasma levels was observed at the 7^th day of therapy, probably in relation to the resolution of inflammatory symptoms. In the same patients IFNγ plasma levels decreased during treatment while IL-10 plasma levels were unaffected.

Keywords:

• Clarithromycin
• amoxicillin
• interleukin-6
• interferon-γ
• interleukin-10