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Antimicrobial Agents and Chemotherapy, February 2002, p. 409-412, Vol. 46, No. 2
0066-4804/01/$04.00+0     DOI: 10.1128/AAC.46.2.409-412.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Effect of Prolonged Treatment with Azithromycin, Clarithromycin, or Levofloxacin on Chlamydia pneumoniae in a Continuous-Infection Model

Andrei Kutlin, Patricia M. Roblin, and Margaret R. Hammerschlag*

Department of Pediatrics, State University of New York Health Science Center at Brooklyn, Brooklyn, New York

Received 4 May 2001/ Returned for modification 14 August 2001/ Accepted 4 November 2001

Persistent infections with Chlamydia pneumoniae have been implicated in the development of chronic diseases, such as atherosclerosis and asthma. Although azithromycin, clarithromycin, and levofloxacin are frequently used for the treatment of respiratory C. pneumoniae infections, little is known about the dose and duration of therapy needed to treat a putative chronic C. pneumoniae infection. In this study, we investigated the effect of prolonged treatment with azithromycin, clarithromycin, or levofloxacin on the viability of C. pneumoniae and cytokine production in an in vitro model of continuous infection. We found that a 30-day treatment with azithromycin, clarithromycin, and levofloxacin at concentrations comparable to those achieved in the pulmonary epithelial lining fluid reduced but did not eliminate C. pneumoniae in continuously infected HEp-2 cells. All three antibiotics decreased levels of interleukin-6 (IL-6) and IL-8 in HEp-2 cells, but this effect appeared to be secondary to the antichlamydial activity, as the cytokine levels correlated with the concentrations of microorganisms. The levels of IL-1ß, IL-4, IL-10, tumor necrosis factor alpha, and gamma interferon were too low to assess the effect of antibiotics. These data suggest that the dosage and duration of antibiotic therapy currently being used may not be sufficient to eradicate a putative chronic C. pneumoniae infection.

* Corresponding author. Mailing address: Department of Pediatrics, Box 49, SUNY Downstate Medical Center at Brooklyn, 450 Clarkson Ave., Brooklyn, NY 11203-2098. Phone: (718) 245-4075. Fax: (718) 245-2118. E-mail: mhammmerschlag{at}pol.net.

Antimicrobial Agents and Chemotherapy, February 2002, p. 409-412, Vol. 46, No. 2
0066-4804/01/$04.00+0     DOI: 10.1128/AAC.46.2.409-412.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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