Intravenous clarithromycin: A valuable immunomodulator for severe infections

There are many studies suggesting that intake of a macrolide in the treatment regimen is linked with improved outcomes for patients with community-acquired pneumonia. However this was never proved through one randomized clinical study (RCT). We reviewed all pre-clinical and clinical development from 2003 to 2014 for intravenous clarithromycin as adjunctive treatment of severe infections. This process ended with the conduct of two RCTs; the first in 200 patients with ventilator-associated pneumonia; and the second in 600 patients with proven or suspected Gram-negative infections of non-pulmonary origin. The two RCTs has similar findings; significant decrease of mortality of patients with septic shock and multiple organ dysfunctions; and shorter resolution of severe infections. The second RCT also showed significant savings for survivors. These data support the use of intravenous clarithromycin as adjunctive treatment of severe infections