Empiric azithromycin alters the upper respiratory microbiome and resistome without anti-inflammatory benefit in COVID-19.

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Title: Empiric azithromycin alters the upper respiratory microbiome and resistome without anti-inflammatory benefit in COVID-19.
Authors: Glascock A; Chan Zuckerberg Biohub San Francisco, San Francisco, CA, USA., Maguire C; University of Texas at Austin, Austin, TX, USA., Phan HV; University of California San Francisco, San Francisco, CA, USA., Lydon EC; University of California San Francisco, San Francisco, CA, USA., Schaenman J; University of California Los Angeles, Los Angeles, CA, USA., Calfee CS; University of California San Francisco, San Francisco, CA, USA., Melamed E; University of Texas at Austin, Austin, TX, USA., Greenland J; University of California San Francisco, San Francisco, CA, USA., Corry DB; Baylor College of Medicine and the Center for Translational Research on Inflammatory Diseases, Houston, TX, USA., Kheradmand F; Baylor College of Medicine and the Center for Translational Research on Inflammatory Diseases, Houston, TX, USA., Baden LR; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Sekaly R; Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH, USA., McComsey GA; Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH, USA., Haddad EK; Drexel University, Tower Health Hospital, Philadelphia, PA, USA., Cairns CB; Drexel University, Tower Health Hospital, Philadelphia, PA, USA., Geng LN; Stanford University School of Medicine, Palo Alto, CA, USA., Pulendran B; Stanford University School of Medicine, Palo Alto, CA, USA., Fernandez-Sesma A; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Simon V; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, New York, NY, USA.; The Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Metcalf JP; Oklahoma University Health Sciences Center, Oklahoma City, OK, USA., Agudelo Higuita NI; Oklahoma University Health Sciences Center, Oklahoma City, OK, USA., Messer WB; Oregon Health and Science University, Portland, OR, USA., Davis MM; Stanford University School of Medicine, Palo Alto, CA, USA., Nadeau KC; Stanford University School of Medicine, Palo Alto, CA, USA., Kraft M; University of Arizona, Tucson, AZ, USA., Bime C; University of Arizona, Tucson, AZ, USA., Erle DJ; University of California San Francisco, San Francisco, CA, USA., Atkinson MA; University of Florida, Gainesville, FL, USA., Brakenridge SC; University of Florida, Gainesville, FL, USA., Ehrlich LIR; University of Texas at Austin, Austin, TX, USA., Montgomery RR; Yale School of Medicine, New Haven, CT, USA., Shaw AC; Yale School of Medicine, New Haven, CT, USA., Hough CL; Oregon Health and Science University, Portland, OR, USA., Hafler DA; Yale School of Medicine, New Haven, CT, USA.; Broad Institute of MIT and Harvard, Cambridge, MA, USA., Augustine AD; National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA., Becker PM; National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA., Peters B; La Jolla Institute for Immunology, La Jolla, CA, USA., Ozonoff A; Broad Institute of MIT and Harvard, Cambridge, MA, USA.; Precision Vaccines Program, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.; Boston Children's Hospital and Harvard Medical School, Boston, MA, USA., Hoch A; Clinical and Data Coordinating Center (CDCC) Precision Vaccines Program, Boston Children's Hospital, Boston, MA, USA., Kim-Schulze S; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Krammer F; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Ignaz Semmelweis Institute, Interuniversity Institute for Infection Research, Medical University of Vienna, Vienna, Austria.; Ludwig Boltzmann Institute for Science Outreach and Pandemic Preparedness at the Medical University of Vienna, Vienna, Austria., Bosinger S; Emory School of Medicine, Atlanta, GA, USA., Eckalbar W; University of California San Francisco, San Francisco, CA, USA., Altman MC; Benaroya Research Institute, University of Washington, Seattle, WA, USA., Wilson M; University of California San Francisco, San Francisco, CA, USA., Guan L; Yale School of Public Health, New Haven, CT, USA., Maecker H; Stanford University School of Medicine, Palo Alto, CA, USA., Steen H; Precision Vaccines Program, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.; Boston Children's Hospital and Harvard Medical School, Boston, MA, USA., Diray-Arce J; Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.; Clinical and Data Coordinating Center (CDCC) Precision Vaccines Program, Boston Children's Hospital, Boston, MA, USA., Rouphael N; Emory School of Medicine, Atlanta, GA, USA., Kleinstein SH; Yale School of Public Health, New Haven, CT, USA., Jayavelu ND; Benaroya Research Institute, University of Washington, Seattle, WA, USA., Reed EF; University of California Los Angeles, Los Angeles, CA, USA., Levy O; Broad Institute of MIT and Harvard, Cambridge, MA, USA.; Precision Vaccines Program, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.; Boston Children's Hospital and Harvard Medical School, Boston, MA, USA., Chu VT; University of California San Francisco, San Francisco, CA, USA., Langelier CR; Chan Zuckerberg Biohub San Francisco, San Francisco, CA, USA. chaz.langelier@ucsf.edu.; University of California San Francisco, San Francisco, CA, USA. chaz.langelier@ucsf.edu.
Corporate Authors: IMPACC Network
Source: Nature microbiology [Nat Microbiol] 2026 Apr; Vol. 11 (4), pp. 1100-1112. Date of Electronic Publication: 2026 Mar 16.
Publication Type: Journal Article; Multicenter Study
Journal Info: Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101674869 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2058-5276 (Electronic) Linking ISSN: 20585276 NLM ISO Abbreviation: Nat Microbiol Subsets: MEDLINE
Database: MEDLINE Ultimate
Description
ISSN:2058-5276
DOI:10.1038/s41564-026-02285-8