TY - JOUR
T1 - Antibiotic-induced endotoxin release in patients with gram-negative urosepsis
T2 - a double-blind study comparing imipenem and ceftazidime
AU - Prins, Jan M.
AU - Van Agtmael, Michiel A.
AU - Kuijper, Ed J.
AU - Van Deventer, Sander J.H.
AU - Speelman, Peter
PY - 1995/9
Y1 - 1995/9
N2 - The clinical significance of differences between antibiotics in endotoxin-liberating potential is unknown. Thirty patients with gram-negative urosepsis were randomized between imipenem and ceftazidime, which have, respectively, a low and a high endotoxin-liberating potential in vitro. In patients treated with ceftazidime, a slower defervescence was noticed. After 4 h of treatment, the blood endotoxin level decreased in all 3 endotoxemic patients receiving imipenem, whereas it increased in 2 of the 4 endotoxemic patients receiving ceftazidime, and in ceftazidime-treated patients, the endotoxin level in urine decreased less than in imipenem-treated subjects. Serum and urine cytokine levels increased 10%—40% after 4 h of ceftazidime treatment compared with no increase in the imipenem-treated patients (P >.05). Endotoxin release during antibiotic killing in vitro, assessed for all microorganisms, was to-fold higher with ceftazidime (P <.001). These results indicate that differences between antibiotics in endotoxin release may affect the inflammatory response during treatment.
AB - The clinical significance of differences between antibiotics in endotoxin-liberating potential is unknown. Thirty patients with gram-negative urosepsis were randomized between imipenem and ceftazidime, which have, respectively, a low and a high endotoxin-liberating potential in vitro. In patients treated with ceftazidime, a slower defervescence was noticed. After 4 h of treatment, the blood endotoxin level decreased in all 3 endotoxemic patients receiving imipenem, whereas it increased in 2 of the 4 endotoxemic patients receiving ceftazidime, and in ceftazidime-treated patients, the endotoxin level in urine decreased less than in imipenem-treated subjects. Serum and urine cytokine levels increased 10%—40% after 4 h of ceftazidime treatment compared with no increase in the imipenem-treated patients (P >.05). Endotoxin release during antibiotic killing in vitro, assessed for all microorganisms, was to-fold higher with ceftazidime (P <.001). These results indicate that differences between antibiotics in endotoxin release may affect the inflammatory response during treatment.
UR - http://www.scopus.com/inward/record.url?scp=0029047395&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/infdis/172.3.886
DO - https://doi.org/10.1093/infdis/172.3.886
M3 - Article
C2 - 7658090
SN - 0022-1899
VL - 172
SP - 886
EP - 891
JO - Journal of infectious diseases
JF - Journal of infectious diseases
IS - 3
ER -