The group of antibiotics that possesses additional anti-inflammatory and immunomodulatory activities is:
MACROLIDE ANTIBIOTICS These are antibiotics having a macrocyclic lactone ring with attached sugars. Erythromycin is the first member discovered in the 1950s, Roxithromycin, Clarithromycin and Azithromycin are the later additions. Interestingly, the nonantibiotic macrolides: tacrolimus, pimecrolimus and sirolimus also possess immunomodulatory propeies. The antibiotic effects of macrolides are mediated by inhibition of bacterial protein synthesis, through inhibiton of peptidyltransferase activity . They have been frequently used in the past for treating many upper respiratory tract infections including GAS pharyngitis with adequate efficacy (>90%) . Their effects on immunomodulation appear to extend beyond their antimicrobial actions as they have been shown to mitigate cytokine production in animal studies and human trials . While its antibiotic propeies have been attributed to mechanisms shared by other macrolides, AZM has been shown to act primarily on the lymphokine CD4 Th1 cell line reducing the production of the proinflammatory cytokines IL-12 and IL-6, and increasing the production of the anti-inflammatory cytokine IL-10 in macrophage cell lines after stimulation with a combination of lipopolysaccharide (LPS) and IFN-g.The immunomodulatory potential of AZM is not limited to suppression of production and secretion of proinflammatory cytokines, it also suppresses iNOS-mediated nitric oxide production. These agents also work at a molecular level, decreasing mRNA expression thereby promoting apoptosis of inflammatory cells and a decrease in nuclear transcription factors. REFERENCE: essentials of medical pharmacology,www.ncbi.nlm.nih.gov
Tetracyclines
Polypeptide antibiotics
Fluoroquinolones
Macrolides
Chemotherapy