ReviewFrontiers in immunology2021
Immunomodulatory Effects of Azithromycin Revisited: Potential Applications to COVID-19.
Review in Frontiers in immunology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Efficacy of Long-Term Use of Azithromycin in the Management of Cystic Fibrosis in Pediatric Patients with or WithoutMedicina (Kaunas, Lithuania) · 2025Pooled it
- Efficacy and safety of azithromycin versus placebo to treat lower respiratory tract infections associated with low procalcitonin: a randomised, placebo-controlled, double-blind, non-inferiority trial.The Lancet. Infectious diseases · 2023Trial
- "The effect of 48-weeks azithromycin therapy on levels of soluble biomarkers associated with HIV-associated chronic lung disease".International immunopharmacology · 2023Trial
- Azithromycin alleviates post-inflammatory wheezing in children by inhibiting SETD1B-mediated histone H3K4me3 methylation and macrophage polarization.Pediatric research · 2026Article
- Azithromycin in Dentistry: From Systemic Antibiotic to a Candidate for Local Therapeutic Delivery.Pharmaceutics · 2026Review
- Article
- Prenatal Azithromycin Exposure and Risk of Neurodevelopmental Disorders in Children.JAMA network open · 2026Article
- Article
- Targeting Bacterial Infections in Periodontal Disease: From Conventional Antibiotics to Next-Generation Therapeutics.Antibiotics (Basel, Switzerland) · 2026Review
- Assessment of pediatric nurses' knowledge of budesonide-formoterol inhaler technique: a cross-sectional study in tertiary hospitals in China.Frontiers in pediatrics · 2026Article
- Mechanisms and Safety of Therapeutic Strategies in Meibomian Gland Dysfunction: A Narrative Review.Ophthalmic research · 2026Review
- Differential Modulation of Macrophage Polarization and NF-κB Signaling by Distinct Antibiotics in an in vitro Acute Inflammatory Model.Journal of inflammation research · 2026Article
- Dual-action thioarylamide-based small molecules to target drug-resistant bacteria and chronic inflammation.iScience · 2025Article
- Antibiotics for Rheumatologic Diseases: A Critical Review.International journal of molecular sciences · 2025Review
- Azithromycin-Induced Stevens-Johnson Syndrome in a Patient With SARS-CoV-2 and End-Stage Renal Disease.Cureus · 2025Article
- Comparative Colonisation Ability of Human Faecal Microbiome Transplantation Strategies in Murine Models.Microbial biotechnology · 2025Article
- Traditional Chinese herbal formulas modulate inflammatory mediators, antioxidant enzyme levels, and ruminal microbiota composition in postpartum female Yaks.Scientific reports · 2025Article
- Glial Modulator Antibiotics for Neuropathic Pain: Current Insights and Future Directions.Pharmaceuticals (Basel, Switzerland) · 2025Review
- The Protective Role of Folic Acid in Biochemical and Histopathological Changes Induced by Azithromycin in the Livers of Pregnant Albino Rats.Medicina (Kaunas, Lithuania) · 2025Article
- Unlocking the Potential of RNA Sequencing in COVID-19: Toward Accurate Diagnosis and Personalized Medicine.Diagnostics (Basel, Switzerland) · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
The rapid advancement of the COVID-19 pandemic has prompted an accelerated pursuit to identify effective therapeutics. Stages of the disease course have been defined by viral burden, lung pathology, and progression through phases of the immune response. Immunological factors including inflammatory cell infiltration and cytokine storm have been associated with severe disease and death. Many immunomodulatory therapies for COVID-19 are currently being investigated, and preliminary results support the premise of targeting the immune response. However, because suppressing immune mechanisms could also impact the clearance of the virus in the early stages of infection, therapeutic success is likely to depend on timing with respect to the disease course. Azithromycin is an immunomodulatory drug that has been shown to have antiviral effects and potential benefit in patients with COVID-19. Multiple immunomodulatory effects have been defined for azithromycin which could provide efficacy during the late stages of the disease, including inhibition of pro-inflammatory cytokine production, inhibition of neutrophil influx, induction of regulatory functions of macrophages, and alterations in autophagy. Here we review the published evidence of these mechanisms along with the current clinical use of azithromycin as an immunomodulatory therapeutic. We then discuss the potential impact of azithromycin on the immune response to COVID-19, as well as caution against immunosuppressive and off-target effects including cardiotoxicity in these patients. While azithromycin has the potential to contribute efficacy, its impact on the COVID-19 immune response requires additional characterization so as to better define its role in individualized therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.