Journal of Antimicrobial Chemotherapy, Vol 39, 13-18, Copyright © 1997 by The British Society for Antimicrobial Chemotherapy
JM Prins, P Speelman, EJ Kuijper, J Dankert and SJ van Deventer
Endotoxin is liberated following antibiotic killing of Gram-negative rods,
and antibiotics may differ in this respect. Although the amount of
filterable endotoxin has also been reported to increase following
antibiotic killing of meningococci, it is unknown how this influences the
host response. We investigated the influence of three antibiotics on levels
of free endotoxin in culture medium and cytokine production in whole blood
ex vivo during killing of four strains of meningococci. Bacterial killing
was significantly more efficient with penicillin or ceftriaxone than with
chloramphenicol, and free endotoxin levels were lower after exposure to
antibiotics as compared with no treatment (ANOVA, P < 0.001). Endotoxin
levels were lowest after exposure to chloramphenicol. In three of the four
strains exposure to antibiotics resulted in considerably lower cytokine
levels (ANOVA, P < 0.001), and TNF-alpha levels were significantly lower
after exposure to penicillin or ceftriaxone than after chloramphenicol
treatment. Only in the strain that induced the lowest levels of TNF-alpha
were cytokine levels comparable for untreated and treated samples. We
conclude that fear of excessive endotoxin release or cytokine production
caused by effective antibiotics is not justified in the treatment of
meningococcal infections.
JOURNAL ARTICLE
No increase in endotoxin release during antibiotic killing of meningococci
Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.
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