Efficacy and safety of carrimycin in ten patients with severe pneumonia following solid organ transplantation

Abstract

Background: The number of patients undergoing solid organ transplantation has increased annually. However, infections in solid organ transplant recipients can have a severe effect on patient survival owing to the continued use of immunosuppressants. Carrimycin is a novel macrolide antibiotic produced by genetically engineered streptomyces spiramyceticus harboring a 4''-O-isovaleryltransferase gene (ist) from streptomyces thermotoleran. Carrimycin has good antibacterial and antiviral effects. However, no relevant studies have been conducted on the efficacy and safety of carrimycin in patients with severe pneumonia (SP) after solid organ transplantation.

Aim: To explore the efficacy and safety of carrimycin in patients with SP after solid organ transplantation to provide a medication reference for clinical treatment.

Methods: In March 2022, ten patients with SP following solid-organ transplantation were treated at our hospital between January 2021 and March 2022. When the condition was critical and difficult to control with other drugs, carrimycin was administered. These ten patients' clinical features and treatment protocols were retrospectively analyzed, and the efficacy and safety of carrimycin for treating SP following solid organ transplantation were evaluated.

Results: All ten patients were included in the analysis. Regarding etiological agent detection, there were three cases of fungal pneumonia, two cases of bacterial pneumonia, two cases of Pneumocystis pneumonia, and three cases of mixed infections. After treatment with carrimycin, the disease in seven patients significantly improved, the course of the disease was significantly shortened, fever was quickly controlled, chest computed tomography was significantly improved, and oxygenation was significantly improved. Finally, the patients were discharged after curing. One patient died of acute respiratory distress syndrome, and two patients discontinued treatment.

Conclusion: Carrimycin is a safe and effective treatment modality for SP following solid organ transplantation. Carrimycin may have antibacterial and antiviral effects in patients with SP following solid organ transplantation.

Keywords: Antiviral drugs; Carrimycin; Immunosuppressant; Infection; Organ transplantation; Severe pneumonia.

Figure 1

Chest computed tomography images before and after treatment with carrimycin. A: Chest computed tomography (CT) images before treatment with carrimycin; B: Chest CT images after treatment with carrimycin.

Figure 2

Molecular structure of three main components of carrimycin. Isovaleryl spiramycin I: R = H, molecular formula: C48H82N2O15, molecular weight: 926; Isovaleryl spiramycin II: R = COCH3, molecular formula: C50H84N2O16, molecular weight: 968; Isovaleryl spiramycin III: R = COCH2COCH3, molecular formula: C51H86N2O16, molecular weight: 982.