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Antimicrob Agents Chemother. 2018 Jan 25;62(2). pii: e01995-17. doi: 10.1128/AAC.01995-17. Print 2018 Feb.

Azithromycin Pharmacodynamics against Persistent Haemophilus influenzae in Chronic Obstructive Pulmonary Disease.

Author information

1
Laboratory for Antimicrobial Pharmacodynamics, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, the State University of New York, Buffalo, New York, USA.
2
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA.
3
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University at Buffalo, the State University of New York, Buffalo, New York, USA.
4
Veterans Affairs Western New York Healthcare System, Buffalo, New York, USA.
5
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA melinda.pettigrew@yale.edu murphyt@buffalo.edu.
6
Division of Infectious Diseases, University at Buffalo, the State University of New York, Buffalo, New York, USA melinda.pettigrew@yale.edu murphyt@buffalo.edu.
7
Clinical and Translational Research Center, University at Buffalo, the State University of New York, Buffalo, New York, USA.
8
Department of Microbiology and Immunology, University at Buffalo, the State University of New York, Buffalo, New York, USA.

Abstract

The pharmacodynamic profile of azithromycin against persistent strains of nontypeable Haemophilus influenzae (NTHi) from chronic obstructive pulmonary disease (COPD) patients was characterized. Azithromycin displayed differential concentration-dependent activities (R2 ≥ 0.988); the pharmacodynamic response was attenuated when we compared the "first" and "last" strains of NTHi that persisted in the airways of the same patient for 819 days (the 50% effective concentration [EC50] increased more than 50 times [0.0821 mg/liter versus 4.23 mg/liter]). In the hollow-fiber infection model, NTHi viability was maintained throughout simulated azithromycin (Zithromax) Z-Pak regimens over 10 days.

KEYWORDS:

azithromycin; macrolide-lincosamide-streptogramin B; nontypeable H. influenzae

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