PT - JOURNAL ARTICLE AU - Andrea Sauer AU - Konrad Peukert AU - Christian Putensen AU - Christian Bode TI - Antibiotics as immunomodulators: a potential pharmacologic approach for ARDS treatment AID - 10.1183/16000617.0093-2021 DP - 2021 Dec 31 TA - European Respiratory Review PG - 210093 VI - 30 IP - 162 4099 - http://err.ersjournals.com/content/30/162/210093.short 4100 - http://err.ersjournals.com/content/30/162/210093.full SO - EUROPEAN RESPIRATORY REVIEW2021 Dec 31; 30 AB - First described in the mid-1960s, acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure with an overall mortality rate of approximately 40%. Despite significant advances in the understanding and treatment of ARDS, no substantive pharmacologic therapy has proven to be beneficial, and current management continues to be primarily supportive. Beyond their antibacterial activity, several antibiotics such as macrolides and tetracyclines exert pleiotropic immunomodulatory effects that might be able to rectify the dysregulated inflammatory response present in patients with ARDS. This review aims to provide an overview of preclinical and clinical studies that describe the immunomodulatory effects of antibiotics in ARDS. Moreover, the underlying mechanisms of their immunomodulatory properties will be discussed. Further studies are necessary to investigate their full therapeutic potential and to identify ARDS phenotypes which are most likely to benefit from their immunomodulatory effects.ARDS carries an unacceptably high mortality. No effective pharmacological therapy has been identified underlining the need for new therapeutic agents. Antibiotics are promising immunomodulators that may reverse the uncontrolled immune response in ARDS. https://bit.ly/3r9ApH3