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Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis

Gijs, Pieter-Jan; Daccord, Cécile; Bernasconi, Eric; Brutsche, Martin; Clarenbach, Christian F; Hostettler, Katrin; Guler, Sabina A; Mercier, Louis; Ubags, Niki; Funke-Chambour, Manuela; von Garnier, Christophe (2023). Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis. ERJ Open Research, 9(3):00720-2022.

Abstract

BackgroundHigh bacterial burden in the lung microbiota predicts progression of idiopathic pulmonary fibrosis (IPF). Azithromycin (AZT) is a macrolide antibiotic known to alter the lung microbiota in several chronic pulmonary diseases, and observational studies have shown a positive effect of AZT on mortality and hospitalisation rate in IPF. However, the effect of AZT on the lung microbiota in IPF remains unknown.MethodsWe sought to determine the impact of a 3-month course of AZT on the lung microbiota in IPF. We assessed sputum and oropharyngeal swab specimens from 24 adults with IPF included in a randomised controlled crossover trial of oral AZT 500 mg 3 times per week. 16S rRNA gene amplicon sequencing and quantitative PCR (qPCR) were performed to assess bacterial communities. Antibiotic resistance genes (ARGs) were assessed using real-time qPCR.ResultsAZT significantly decreased community diversity with a stronger and more persistent effect in the lower airways (sputum). AZT treatment altered the temporal kinetics of the upper (oropharyngeal swab) and lower airway microbiota, increasing community similarity between the two sites for 1 month after macrolide cessation. Patients with an increase in ARG carriage had lower bacterial density and enrichment of the genusStreptococcus. In contrast, patients with more stable ARG carriage had higher bacterial density and enrichment inPrevotella.ConclusionsAZT caused sustained changes in the diversity and composition of the upper and lower airway microbiota in IPF, with effects on the temporal and spatial dynamics between the two sites.

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Pneumology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Pulmonary and Respiratory Medicine
Uncontrolled Keywords:Pulmonary and Respiratory Medicine
Language:English
Date:1 May 2023
Deposited On:01 Dec 2023 09:32
Last Modified:30 Oct 2024 02:38
Publisher:European Respiratory Society
ISSN:2312-0541
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1183/23120541.00720-2022
PubMed ID:37228285
Project Information:
  • Funder: Lungenliga Schweiz
  • Grant ID:
  • Project Title:
  • Funder: ligue pulmonaire vaudoise
  • Grant ID:
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