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Mechanism of Action, Resistance, Synergism, and Clinical Implications of Azithromycin Publisher Pubmed



Heidary M1, 2 ; Ebrahimi Samangani A3 ; Kargari A3 ; Kiani Nejad A3 ; Yashmi I3 ; Motahar M4 ; Taki E5 ; Khoshnood S6
Authors
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Authors Affiliations
  1. 1. Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
  2. 2. Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
  3. 3. Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
  4. 4. Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  5. 5. Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran

Source: Journal of Clinical Laboratory Analysis Published:2022


Abstract

Background: Azithromycin (AZM), sold under the name Zithromax, is classified as a macrolide. It has many benefits due to its immunomodulatory, anti-inflammatory, and antibacterial effects. This review aims to study different clinical and biochemisterial aspects and properties of this drug which has a priority based on literature published worldwide. Methods: Several databases including Web of Science, Google Scholar, PubMed, and Scopus were searched to obtain the relevant studies. Results: AZM mechanism of action including the inhibition of bacterial protein synthesis, inhibition of proinflammatory cytokine production, inhibition of neutrophil infestation, and macrophage polarization alteration, gives it the ability to act against a wide range of microorganisms. Resistant organisms are spreading and being developed because of the irrational use of the drug in the case of dose and duration. AZM shows synergistic effects with other drugs against a variety of organisms. This macrolide is considered a valuable antimicrobial agent because of its use as a treatment for a vast range of diseases such as asthma, bronchiolitis, COPD, cystic fibrosis, enteric infections, STIs, and periodontal infections. Conclusions: Our study shows an increasing global prevalence of AZM resistance. Thus, synergistic combinations are recommended to treat different pathogens. Moreover, continuous monitoring of AZM resistance by registry centers and the development of more rapid diagnostic assays are urgently needed. © 2022 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.