NAC for Bacterial Infection:

BENEFITS AND MECHANISMS:

Antioxidant: direct and indirect.
Conjugating agent to neutralize toxins
Mucolytic: NAC dissolves mucus so a patient can cough up mucus to clear their airway.
Dissolves biofilms

Antiinflammatory

Immunopotentiation: Enhances immune defenses against viruses and bacteria, and other pathogens.

Antiviral: influenza, HIV, dengue, corona, etc

Anticatabolic/anticachexic, anti-wasting, spares glutamine

Mitoprotective
Neuroprotecticve
Enhance dopamine, reduces glutamin
Lowers Homocystine
Appetite suppression – supports fat loss while maintaining muscle mass
Chelates heavy metal toxicity

NAC FDA approved and used in hospitals for acetaminophen toxicity where it is over 97% effective if taken within 8 hours of overdose.

Loading dose of 140 mg/kg oral NAC can be life saving

NAC dissolves mucus so a patient can cough up mucus to clear their airway (mucolytic effect). Used to treat lung disease for both antiviral and antibacterial infection.

SAFETY: Oral NAC is remarkably safe even from very large doses.

N-acetylcysteine for antioxidant therapy: pharmacology and clinical utility

“NAC has a benign side effect profile that does not differ significantly from placebo in most clinical trials [10,11,21,37,70]. Mild gastrointestinal symptoms are the most common side effects [21] however, when used as a mucolytic agent it has been reported to cause local irritation [71].”

The effect of N-acetylcysteine on biofilms: Implications for the treatment of respiratory tract infections

“Evidence from in vitro studies indicates that NAC has good antibacterial properties and the ability to interfere with biofilm formation and disrupt biofilms.”

Role of Cysteine and Glutathione in HIV Infection and Cancer Cachexia: Therapeutic Intervention with N-Acetylcysteine

The intrabronchial microbial flora in chronic bronchitis patients: a target for N-acetylcysteine therapy?

“An interesting finding was that the ratio of significant intrabronchial bacterial growth was lower in the patients with chronic bronchitis treated with oral NAC medication than in the patients without this therapy. The difference was most pronounced for the patients with COPD and statistically significant even with our relatively small number of patients. For the 11 COPD patients with NAC medication, this was so evident that the results of their bacterial cultures was almost a reflection of those of the 13 healthy controls.”

Therapeutic blockade of inflammation in severe COVID-19 infection with intravenous N-acetylcysteine

“NAC administration allowed the discontinuation of ECMO and eventual discharge of the patient to his home.”

Efficacy of N-acetylcysteine in preventing atrial fibrillation after cardiac surgery: a meta-analysis of published randomized controlled trials

”50 mg/kg iv for 1 h before surgery, then 50 mg/kg/day 48 h after operation”