Investigating Azithromycin Activity Against ESBL-Producing <i>Escherichia coli</i> Under Physiologically Relevant Conditions

Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli are a major antimicrobial resistance threat. Although not standard therapy, azithromycin (AZM) displayed potent activity against ESBL E. coli in vitro, ex vivo, and in vivo. AZM demonstrated multi-fold reductions in MIC, bactericidal activity in supplemented mammalian tissue culture media, and enhanced dose-dependent activity with sodium bicarbonate (NaHCO3). AZM also augmented complement-mediated killing in human serum and improved survival by 50% in a murine bloodstream infection model. These findings underscore the need to revisit antibiotic susceptibility testing-incorporating host defense factors and NaHCO3-and suggest AZM merits further clinical evaluation for ESBL E. coli infections.

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Publication Details

Journal
The Journal of Infectious Diseases
Published
2025-09-16
DOI
https://doi.org/10.1093/infdis/jiaf480
Citations
1
Primary Topic
Antibiotic Resistance in Bacteria
Type
article
Field-Weighted Citation Impact
0.59
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Investigating Azithromycin Activity Against ESBL-Producing Escherichia coli Under Physiologically Relevant Conditions

Sérgio Machado Corrêa, Elisabet Bjånes, Monika Kumaraswamy, Samira Dahesh et al.
1 citations
The Journal of Infectious Diseases
Antibiotic Resistance in Bacteria
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Investigating Azithromycin Activity Against ESBL-Producing Escherichia coli Under Physiologically Relevant Conditions

Sérgio Machado Corrêa, Elisabet Bjånes, Monika Kumaraswamy, Samira Dahesh, Alexandria Hoffman, Victor Nizet, Hunter Gage, Jonathan M. Monk, Natalie Chavarria, Si Young Jung
article en
1 citations

Abstract

Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli are a major antimicrobial resistance threat. Although not standard therapy, azithromycin (AZM) displayed potent activity against ESBL E. coli in vitro, ex vivo, and in vivo. AZM demonstrated multi-fold reductions in MIC, bactericidal activity in supplemented mammalian tissue culture media, and enhanced dose-dependent activity with sodium bicarbonate (NaHCO3). AZM also augmented complement-mediated killing in human serum and improved survival by 50% in a murine bloodstream infection model. These findings underscore the need to revisit antibiotic susceptibility testing-incorporating host defense factors and NaHCO3-and suggest AZM merits further clinical evaluation for ESBL E. coli infections.

The Journal of Infectious DiseasesVol. 233(1)
The University of Texas at Tyler (US), UC San Diego Health System (US), University of California San Diego (US), VA San Diego Healthcare System (US), La Jolla Bioengineering Institute (US), University of Montana (US), The University of Texas Health Science Center at Tyler (US)
Openalex Percentile: Top 30%
Antibiotic Resistance in Bacteria
0.59
DOIOpen Access PDFOpenAlex
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