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Several studies have shown improved outcomes after the addition of macrolides to \u03b2-lactam antibiotics for treatment of severe community-acquired pneumonia. However, a beneficial effect of macrolides in treating Gram-negative bacterial airway infections, e.g., those caused by<jats:named-content content-type=\"genus-species\">Pseudomonas aeruginosa<\/jats:named-content>, remains to be shown. Macrolide antibiotics have significant side effects, in particular, motility-stimulating activity in the gastrointestinal tract and promotion of bacterial resistance. In this study, EM703, a modified macrolide lacking antibiotic and motility-stimulating activities but with retained anti-inflammatory properties, was used as an adjunct treatment for experimental<jats:named-content content-type=\"genus-species\">P. aeruginosa<\/jats:named-content>lung infection, in combination with a conventional antibiotic. Airway infections in BALB\/cJRj mice were induced by nasal instillation of<jats:named-content content-type=\"genus-species\">P. aeruginosa<\/jats:named-content>; this was followed by treatment with the quinolone levofloxacin in the absence or presence of EM703. Survival, inflammatory responses, and cellular influx to the airways were monitored. Both pretreatment and simultaneous administration of EM703 dramatically improved survival in levofloxacin-treated mice with<jats:named-content content-type=\"genus-species\">P. aeruginosa<\/jats:named-content>airway infections. In addition, EM703 reduced the levels of proinflammatory cytokines, increased the numbers of leukocytes in bronchoalveolar lavage fluid, and reduced the numbers of neutrophils present in lung tissue. In summary, the findings of this study show that the immunomodulatory properties of the modified macrolide EM703 can be important when treating Gram-negative pneumonia, as exemplified by<jats:named-content content-type=\"genus-species\">P. aeruginosa<\/jats:named-content>infection in this study.<\/jats:p>","DOI":"10.1128\/aac.02761-16","type":"journal-article","created":{"date-parts":[[2017,6,27]],"date-time":"2017-06-27T00:30:31Z","timestamp":1498523431000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":14,"title":["The Nonantibiotic Macrolide EM703 Improves Survival in a Model of Quinolone-Treated Pseudomonas aeruginosa Airway Infection"],"prefix":"10.1128","volume":"61","author":[{"given":"Gopinath","family":"Kasetty","sequence":"first","affiliation":[{"name":"Respiratory Medicine &amp; Allergology, Department of Clinical Sciences Lund, Lund University, Sk\u00e5ne University Hospital, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6648-1781","authenticated-orcid":false,"given":"Ravi K. 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