Treatment with Atorvastatin Provides Additional Benefits to Imipenem in a Model of Gram-Negative Pneumonia Induced by Klebsiella pneumoniae in Mice

Antimicrob Agents Chemother. 2018 Apr 26;62(5):e00764-17. doi: 10.1128/AAC.00764-17. Print 2018 May.

Abstract

The clinical pathogen Klebsiella pneumoniae is a relevant cause of nosocomial infections, and resistance to current treatment with carbapenem antibiotics is becoming a significant problem. Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) used for controlling plasma cholesterol levels. There is clinical evidence showing other effects of statins, including decrease of lung inflammation. In the current study, we show that pretreatment with atorvastatin markedly attenuated lung injury, which was correlated with a reduction in the cellular influx into the alveolar space and lungs and downmodulation of the production of proinflammatory mediators in the initial phase of infection in C57BL/6 mice with K. pneumoniae However, atorvastatin did not alter the number of bacteria in the lungs and blood of infected mice, despite decreasing local inflammatory response. Interestingly, mice that received combined treatment with atorvastatin and imipenem displayed better survival than mice treated with vehicle, atorvastatin, or imipenem alone. These findings suggest that atorvastatin could be an adjuvant in host-directed therapies for multidrug-resistant K. pneumoniae, based on its powerful pleiotropic immunomodulatory effects. Together with antimicrobial approaches, combination therapy with anti-inflammatory compounds could improve the efficiency of therapy during acute lung infections.

Keywords: Klebsiella pneumoniae; atorvastatin; combination therapy; imipenem; lung inflammation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use*
  • Atorvastatin / therapeutic use*
  • Bacterial Load / drug effects
  • Chemokines / analysis
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology
  • Drug Resistance, Multiple, Bacterial
  • Drug Therapy, Combination
  • Female
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Imipenem / therapeutic use*
  • Inflammation / drug therapy
  • Klebsiella Infections / drug therapy*
  • Klebsiella pneumoniae / drug effects*
  • Macrophages / immunology
  • Mice
  • Mice, Inbred C57BL
  • Neutrophils / immunology
  • Phagocytosis / drug effects
  • Phagocytosis / immunology
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / microbiology

Substances

  • Anti-Bacterial Agents
  • Chemokines
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Imipenem
  • Atorvastatin