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Ceftazidime- and Imipenem-Induced Endotoxin Release During Treatment of Gram-Negative Infections

  • B. Byl
  • P. Clevenbergh
  • A. Kentos
  • F. Jacobs
  • A. Marchant
  • J. Vincent
  • J. Thys
Article

Abstract.

To determine whether ceftazidime and imipenem, which target two different penicillin-binding proteins, result in different amounts of endotoxin and cytokine release in patients with gram-negative infection, plasma endotoxin, interleukin-6, and tumor necrosis factor alpha were measured during the first 24 h of antibiotic therapy in 27 patients with gram-negative infection who had been randomized to receive either ceftazidime 2 g t.i.d. (n=12) or imipenem/cilastatin 1 g t.i.d. (n=15). The source of infection was the digestive tract (n=13), the urinary tract (n=5), the respiratory tract (n=2), soft tissue (n=2), i.v. line (n=2), or other (n=3). After the first antibiotic injection, a significant increase in the median concentration of plasma interleukin-6 and plasma tumor necrosis factor alpha was noted, without significant differences related to the antibiotic administered. Antibiotic-induced endotoxemia was detectable in nine patients (including 7 with bacteremia). In conclusion, ceftazidime and imipenem had similar effects on endotoxin and cytokine release during the treatment of gram-negative infections.

Keywords

Ceftazidime Imipenem Simplified Acute Physiology Score Meningococcal Disease Endotoxin Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • B. Byl
    • 1
  • P. Clevenbergh
    • 1
  • A. Kentos
    • 1
  • F. Jacobs
    • 1
  • A. Marchant
    • 2
  • J. Vincent
    • 3
  • J. Thys
    • 1
  1. 1.Infectious Diseases Clinic, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, BelgiumBelgium
  2. 2.Department of Immunology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, BelgiumBelgium
  3. 3.Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, BelgiumBelgium

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