Azitromicin je antibiotik široka spektra djelovanja iz skupine makrolidnih antibiotika i ima snažno imunomodulatorno djelovanje. Bez obzira na zasad malen broj radova o ovom iznimno važnom svojstvu azitromicina, iz dostupne se literature lako razaznaje njegov potencijal imunomodulatornog djelovanja na razini stanica i tkiva te u različitim kliničkim entitetima, ponajprije u patologiji različitih akutnih i kroničnih respiratornih poremećaja i infekcija. Azitromicin se nakuplja u nizu stanica i djeluje imunomodulatorno na njih preko različitih imunosnih mehanizama (epitelne stanice, fibroblasti, monociti/makrofagi, dendritičke stanice, NK-stanice, T-limfociti, neutrofili, mastociti, eozinofili). Ograničen broj kliničkih studija upućuje na imunomodulatorno djelovanje azitromicina u različitim infekcijama, u prvom redu respiratornim, a onda i infekcijama kože i potkožnog tkiva, spolno prenosivim bolestima i infekcijama te bolestima gastrointestinalnog trakta. Većina njih u svojim se zaključcima dijelom oslanja na različite kalkulacije o imunomodulatornom djelovanju azitromicina, bazirane na studijama in vitro ili ex vivo. Učinkovito antimikrobno djelovanje azitromicina na brojne mikroorganizme, udruženo s njegovim potentnim imunomodulatornim djelovanjem, čini ovaj lijek snažnim terapeutikom ne samo u akutnim nego i u kroničnim infekcijama, ali i u nekim kliničkim entitetima i kroničnim bolestima za koje nije dokazan infektivni uzročnik.Azithromycin is a broad-spectrum antibiotic from a group of macrolide antibiotics that has a strong immunomodulatory effect. Relatively few papers focusing on this extremely important property of azithromycin have been published so far. Nevertheless, available literature reveals its enormous potential for immunomodulatory effect at the cell and tissue level and in various clinical entities, primarily in the pathology of various acute and chronic respiratory disorders and infections. Accumulating within a whole string of cells, azithromycin uses different immune mechanisms (epithelial cells, fibroblasts, monocytes/macrophages, dendritic cells, NK cells, T lymphocytes, neutrophils, mast cells, eosinophils) to exert its immunomodulatory effect. A limited number of clinical studies indicate the immunomodulatory effect of azithromycin in various infections, primarily respiratory infections, as well as in skin and subcutaneous tissue infections, sexually transmitted diseases and gastrointestinal infections and diseases. In most of these studies, conclusions regarding the immunomodulatory effect of azithromycin are, in part, based on various calculations supported by in vitro or ex vivo studies. Given its effective antimicrobial activity against numerous microorganisms, together with its potent immunomodulatory effect, azithromycin is an effective therapeutic drug indicated for the treatment of both acute and chronic infections, as well as certain clinical entities and chronic diseases for which no infectious agent has been proven
