Heparin-azithromycin microparticulate nasal gels block SARS-CoV-2 and bacterial respiratory infections

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Anaya, Bryan J. and Osouli-Bostanabad, Karim and Tirado, Diego F. and González-Burgos, Elena and Lalatsa, Aikaterini and Serrano, Dolores R. (2025) Heparin-azithromycin microparticulate nasal gels block SARS-CoV-2 and bacterial respiratory infections. Carbohydrate Polymer Technologies and Applications, 12. 101031. ISSN 2666-8939 (https://doi.org/10.1016/j.carpta.2025.101031)

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Abstract

The SARS-CoV-2 pandemic highlighted the need for effective prophylactic and local treatment strategies against respiratory viruses. The nasal cavity is a critical site for pathogen entry and colonization, and is therefore a critical target for targeted interventions. SARS-CoV-2, as a plethora of other virus, primarily spreads via respiratory droplets infecting nasal epithelial cells. Concurrently, bacteria such as Streptococcus pneumoniae and Pseudomonas aeruginosa, frequently colonize the nasal cavity, causing co-infections and serving as reservoirs for further respiratory tract involvement. This study presents a nasal gel that combines heparin and azithromycin (AZM) microparticles to combat both viral and bacterial infections in the nasal cavity. The formulation exhibits a favorable safety profile with minimal haemolytic toxicity (HC 50 > 82 × 10⁷ μg/mL), potent activity against P. aeruginosa and S. pneumoniae at low concentrations (MIC of 15.6 µg/mL and 7.8 µg/mL, respectively), and effective antiviral properties (IC 50 of 0.062 µg/mL for Pseudovirus inhibition). These multifaceted properties position the formulation as a promising candidate for a convenient, dual-action therapy in respiratory infection management, offering potentially both treatment and prophylaxis.

ORCID iDs

Anaya, Bryan J., Osouli-Bostanabad, Karim ORCID logoORCID: https://orcid.org/0000-0003-4375-4948, Tirado, Diego F., González-Burgos, Elena, Lalatsa, Aikaterini ORCID logoORCID: https://orcid.org/0000-0003-4791-7468 and Serrano, Dolores R.;
CORE (COnnecting REpositories)