Objective To study endotoxin release induced by differential antibiotics in gram negative bacterial infection.
Methods Thirty critical patients accompanied with gram negative bacterial infection were divided into group A (imipenem group, n=15) and group B (ceftazidine group, n=15). Imipenem (0.5 g iv q8h) and ceftazidine (1.0 g iv q8h) were given respectively. White blood cell (WBC), systolic blood pressure (SBP), lipopoly sacchride (LPS), tumor necrosis factor alpha (TNFα) and high density lipoprotein (HDL) were determined in 0, 1, 2, 3, 5 and 7 day.
Results There was no difference in the change of WBC between two groups. Group A had a more stable SBP than group B. There was lower endotoxin release in group A than in group B and so were the cytokines release. HDL level was lower in group B than in group A.
Conclusion Imipenem has lower endotoxinliberating potential than ceftazidine and mediate lower cytokines release. HDL may protect the patients from LPS damage.
Citation：
KANG Yan,JING Xiaodong,WU Shuhong,et al.. A Study of Endotoxin Release Induced by Different Antibiotics in Gram Negative Bacterial Infection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(1): 13-15. doi:
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Jackson JJ,Kropp H.BetaLactam antibioticinduced release of free endotoxin: in vitro comparison of penicillinbinding protein(PBP)2specific imipenem and PBP3specific ceftazidine [Ｊ]. J Infect Dis,1992； 165(6)∶ 1033.
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- 1. Hopkin DA. Too rapid destruction of gramnegative organisms [Ｊ]. Lancet,1977； 17(8038)∶ 603.
- 2. Horn DL, Opal SM, Lomastro E. Antibiotics, cytokines, and endotoxin: a complex and evolving relationship in gramnegative sepsis [Ｊ]. Scand J Infect Dis Suppl,1996； 101(1)∶ 9.
- 3. 周向东，阳涛.抗生素杀菌过程致内毒素释放的比较研究 [Ｊ].中华内科杂志,1998； 37(10)∶ 686.
- 4. Norimatsu M, Morrison DC. Correlation of antibioticinduced endotoxin release and cytokine production in Escherichia coliinoculated mouse whole blood ex vivo [Ｊ]. J Infect Dis,1998； 177(5)∶ 1302.
- 5. Bucklin SE, Morrison DC. Differences in therapeutic efficacy among cell wallactive antibiotics in a mouse model of gramnegative sepsis [Ｊ]. J Infect Dis,1995； 172(6)∶ 1519.
- 6. Jackson JJ,Kropp H.BetaLactam antibioticinduced release of free endotoxin: in vitro comparison of penicillinbinding protein(PBP)2specific imipenem and PBP3specific ceftazidine [Ｊ]. J Infect Dis,1992； 165(6)∶ 1033.
- 7. Bryan CS, Harrison RV.Appropriate initial antimicrobial therapy of severe sepsis [Ｊ]. Infect Med,1994； 11(3)∶ 372.
- 8. Ulevitch RJ, Johnston AR, Weinstein DB. New function for high density lipoproteins. Their participation in intravascular reactions of bacterial lipopolysaccharides [Ｊ]. J Clin Invest,1979； 64(5)∶ 1516.
- 9. Harris HW, Grunfeld C, Feingold KR, et al. Human very low density lipoproteins and chylomicrons can protect against endotoxininduced death in mice [Ｊ]. J Clin Invest,1990； 86(3)∶ 696.
