Romany Helmy Thabet*, Sana'a Mahmoud Muflih Bani Amer2, Hamam Hani Nageeb Dwaghreh, Ansam Zakaria Issa Baniamer, Mohammad Rami Mohammad Tbaishat, Erin Maher Wilson
While antibiotics are widely used as antimicrobial agents for treating a variety of bacterial infections, it has been reported that a majority of them also exert antiviral, anti-inflammatory, immunomodulatory, and antioxidant activities that may a significant role in alleviating many clinical disorders such as severe acute respiratory syndrome coronavirus 2 (SAR-SCoV-2). Interestingly, literature mentioned that macrolide antibiotics (e.g., azithromycin) significantly reduce viral replication, downregulate the inflammatory cascade and excessive cytokine production, and decrease mortality. In the same line, fluoroquinolones as moxifloxacin and ciprofloxacin suppress COVID-19 replication, overproduction of nitric oxide in the lungs besides inhibiting inflammatory cell responses. Similarly, various antibiotics, such as doxycycline, clarithromycin, ceftriaxone, amoxicillin, amoxicillin-clavulanic acid, ampicillin, gentamicin, benzylpenicillin, piperacillin/tazobactam, ciprofloxacin, ceftazidime, cefepime, vancomycin, meropenem, and cefuroxime among others, were recommended for use in the management of COVID-19 owing to their pleiotropic activities. The current review illustrates the potential immunologic activities beyond the antibacterial effect of different antibiotics in clinical practice from the pharmacological point of view.
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