{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:56:40Z","timestamp":1782388600272,"version":"3.54.5"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 AI007061"],"award-info":[{"award-number":["T32 AI007061"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plospathogens.org"],"crossmark-restriction":false},"short-container-title":["PLoS Pathog"],"abstract":"<jats:p><jats:italic>Staphylococcus aureus<\/jats:italic> bacteremia (SAB) remains a clinically challenging infection despite extensive investigation. Repurposing medications approved for other indications is appealing as clinical safety profiles have already been established. Ticagrelor, a reversible adenosine diphosphate receptor antagonist that prevents platelet aggregation, is indicated for patients suffering from acute coronary syndrome (ACS). However, some clinical data suggest that patients treated with ticagrelor are less likely to have poor outcomes due to <jats:italic>S<\/jats:italic>. <jats:italic>aureus<\/jats:italic> infection. There are several potential mechanisms by which ticagrelor may affect <jats:italic>S<\/jats:italic>. <jats:italic>aureus<\/jats:italic> virulence. These include direct antibacterial activity, up-regulation of the innate immune system through boosting platelet-mediated <jats:italic>S<\/jats:italic>. <jats:italic>aureus<\/jats:italic> killing, and prevention of <jats:italic>S<\/jats:italic>. <jats:italic>aureus<\/jats:italic> adhesion to host tissues. In this Pearl, we review the clinical data surrounding ticagrelor and infection as well as explore the evidence surrounding these proposed mechanisms of action. While more evidence is needed before antiplatelet medications formally become part of the arsenal against <jats:italic>S<\/jats:italic>. <jats:italic>aureus<\/jats:italic> infection, these potential mechanisms represent exciting pathways to target in the host\/pathogen interface.<\/jats:p>","DOI":"10.1371\/journal.ppat.1010240","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T18:26:06Z","timestamp":1644517566000},"page":"e1010240","update-policy":"https:\/\/doi.org\/10.1371\/journal.ppat.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Antiplatelet therapy for Staphylococcus aureus bacteremia: Will it stick?"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8579-4302","authenticated-orcid":true,"given":"Alexander M.","family":"Tatara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronak G.","family":"Gandhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Mooney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1949-7884","authenticated-orcid":true,"given":"Sandra B.","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,2,10]]},"reference":[{"key":"ppat.1010240.ref001","article-title":"Pharmacological Targeting of the Host\u2013Pathogen Interaction: Alternatives to Classical Antibiotics to Combat Drug-Resistant Superbugs","author":"J Munguia","year":"2017","journal-title":"Trends Pharmacol Sci"},{"key":"ppat.1010240.ref002","article-title":"Platelets Mediate Host Defense against Staphylococcus aureus through Direct Bactericidal Activity and by Enhancing Macrophage Activities","author":"RA Ali","year":"2017","journal-title":"J Immunol"},{"key":"ppat.1010240.ref003","article-title":"Activated platelets kill Staphylococcus aureus, but not Streptococcus pneumoniae\u2014The role of Fc\u03b3RIIa and platelet factor 4\/heparinantibodies","author":"M Wolff","year":"2020","journal-title":"J Thromb Haemost"},{"key":"ppat.1010240.ref004","article-title":"Host defense role of platelets: Engulfment of HIV and Staphylococcus aureus occurs in a specific subcellular compartment and is enhanced by platelet activation","author":"T Youssefian","year":"2002","journal-title":"Blood"},{"key":"ppat.1010240.ref005","article-title":"Crosstalk Between Platelets and Microbial Pathogens.","author":"C Li","year":"2020","journal-title":"Front Immunol"},{"key":"ppat.1010240.ref006","article-title":"Thrombocytopenia in Staphylococcus aureus bacteremia: Risk factors and prognostic importance","author":"A Gafter-Gvili","year":"2011","journal-title":"Mayo Clin Proc"},{"key":"ppat.1010240.ref007","article-title":"Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes","author":"L Wallentin","year":"2009","journal-title":"N Engl J Med"},{"key":"ppat.1010240.ref008","article-title":"Lower mortality following pulmonary adverse events and sepsis with ticagrelor compared to clopidogrel in the PLATO study.","author":"RF Storey","year":"2014","journal-title":"Platelets"},{"key":"ppat.1010240.ref009","article-title":"Risk of infectious events in acute myocardial infarction patients treated with ticagrelor or clopidogrel","author":"CH Lee","year":"2021","journal-title":"Eur J Intern Med"},{"key":"ppat.1010240.ref010","article-title":"Effect of Ticagrelor on Reducing the Risk of Gram-Positive Infections in Patients With Acute Coronary Syndrome.","author":"L Lupu","year":"2020","journal-title":"Am J Cardiol"},{"key":"ppat.1010240.ref011","article-title":"Ticagrelor and the risk of Staphylococcus aureus bacteraemia and other infections","author":"JH Butt","year":"2020","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"ppat.1010240.ref012","article-title":"Antibacterial Activity of Ticagrelor in Conventional Antiplatelet Dosages Against Antibiotic-Resistant Gram-Positive Bacteria","author":"P Lancellotti","year":"2019","journal-title":"JAMA Cardiol"},{"key":"ppat.1010240.ref013","article-title":"Ticagrelor Increases Platelet-Mediated Staphylococcus aureus Killing, Resulting in Clearance of Bacteremia","author":"ER Ulloa","year":"2021","journal-title":"J Infect Dis"},{"key":"ppat.1010240.ref014","article-title":"Repurposed drugs block toxin-driven platelet clearance by the hepatic Ashwell-Morell receptor to clear Staphylococcus aureus bacteremia","author":"J Sun","year":"2021","journal-title":"Sci Transl Med"},{"key":"ppat.1010240.ref015","article-title":"Clumping factor A mediates binding of Staphylococcus aureus to human platelets","author":"IR Siboo","year":"2001","journal-title":"Infect Immun"},{"key":"ppat.1010240.ref016","article-title":"Role of Staphylococcus aureus coagulase and clumping factor in pathogenesis of experimental endocarditis","author":"P Moreillon","year":"1995","journal-title":"Infect Immun"},{"key":"ppat.1010240.ref017","article-title":"Antiplatelet therapy abrogates platelet-assisted Staphylococcus aureus infectivity of biological heart valve conduits","author":"B Ditkowski","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"ppat.1010240.ref018","article-title":"Prophylaxis of experimental endocarditis with antiplatelet and antithrombin agents: A role for long-term prevention of infective endocarditis in humans?","author":"TR Veloso","year":"2015","journal-title":"J Infect Dis"},{"key":"ppat.1010240.ref019","article-title":"Long-term tolerability of ticagrelor for the secondary prevention of major adverse cardiovascular events: A secondary analysis of the PEGASUS-TIMI 54 trial","author":"MP Bonaca","year":"2016","journal-title":"JAMA Cardiol"},{"key":"ppat.1010240.ref020","article-title":"Risk of stroke subsequent to infective endocarditis: A nationwide study","author":"L \u00d8stergaard","year":"2019","journal-title":"Am Heart J"}],"container-title":["PLOS Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.ppat.1010240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T18:26:09Z","timestamp":1644517569000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.ppat.1010240"}},"subtitle":[],"editor":[{"given":"Kimberly A.","family":"Kline","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,2,10]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.ppat.1010240","relation":{},"ISSN":["1553-7374"],"issn-type":[{"value":"1553-7374","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,10]]}}}