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Impact of antibiotic therapy on systemic cytokine expression in pneumococcal pneumonia

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Abstract

The aim of this study was to compare the evolution of systemic cytokine levels over time in patients with pneumococal pneumonia treated either with β-lactam monotherapy or with combination therapy (β-lactam plus fluoroquinolone). Prospective observational study of hospitalized non-immunocompromised adults with PP. Concentrations of IL-6, IL-8, IL-10, and TNF-α were determined on days 0, 1, 2, 3, 5, and 7. Patients on β-lactam monotherapy were compared with those receiving combination therapy. Fifty-two patients were enrolled in the study. Concentrations of IL-6, IL-8, and IL-10 decreased rapidly in the first days after admission, in accordance with the mean time to defervescence. High levels of IL-6 were found in patients with the worst outcomes, measured by the need for intensive care unit admission and mortality. No major differences in demographic or clinical characteristics or severity of disease were found between patients treated with β-lactam monotherapy and those treated with combination therapy. IL-6 levels fell more rapidly in patients with combination therapy in the first 48 h (p = 0.016). Our data suggest that systemic expression of IL-6 production in patients with PP correlates with prognosis. Initial combination antibiotic therapy produces a faster decrease in this cytokine in the first 48 h.

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Acknowledgements

This study was supported by research grants of Fundación Pi I Sunyer; FUCAP (Fundació Catalana de Pneumologia); REIPI RD06/0008 from the Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III, Spanish Network for the Research in Infectious Diseases; by FIS (070864); and by Institut d’Investigació Biomèdica de Bellvitge (Dr. Garcia-Vidal).

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Authors and Affiliations

  1. Respiratory Medicine, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain

    S. Padrones, S. Fernández-Serrano, A. Fernández, F. Manresa & J. Dorca

  2. Infectious Disease, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain

    C. Garcia-Vidal, J. Carratalà & F. Gudiol

  3. Preventive Medicine, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain

    C. Masuet

  4. Immunology, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain

    M. Coromines

  5. Microbiology Departments of Hospital Universitari de Bellvitge, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain

    C. Ardanuy

  6. REIPI (Spanish Network for the Research in Infectious Diseases), Madrid, Spain

    C. Garcia-Vidal, J. Carratalà & F. Gudiol

  7. CIBER de Enfermedades Respiratorias ISCIII, Madrid, Spain

    C. Ardanuy

  8. Infectious Disease Service, Hospital Universitari de Bellvitge, Feixa Llarga s/n 08907, L’Hospitalet, Barcelona, Spain

    C. Garcia-Vidal

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  1. S. Padrones
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  2. C. Garcia-Vidal
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  3. S. Fernández-Serrano
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  4. A. Fernández
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  5. C. Masuet
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  6. J. Carratalà
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  7. M. Coromines
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  8. C. Ardanuy
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  9. F. Gudiol
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  10. F. Manresa
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  11. J. Dorca
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Correspondence to C. Garcia-Vidal.

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Padrones, S., Garcia-Vidal, C., Fernández-Serrano, S. et al. Impact of antibiotic therapy on systemic cytokine expression in pneumococcal pneumonia. Eur J Clin Microbiol Infect Dis 29, 1243–1251 (2010). https://doi.org/10.1007/s10096-010-0993-0

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  • DOI: https://doi.org/10.1007/s10096-010-0993-0

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