Antibiotic Effects Differ In Sepsis

It is becoming established that the administration of antibiotics to patients with sepsis can cause a release of endotoxin and thus contribute to the development of septic shock.

David Morrison of the University of Kansas told the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (in New Orleans, USA) that antibiotics differ regarding the degree of endotoxin release they stimulate. For example, Merck & Co's carbapenem antibiotic imipenem and the cephalosporin ceftazidime are both effective in killing bacteria, but ceftazidime stimulates more endotoxin release than imipenem.

Studies have also shown that imipenem stimulated less cytokine (tumor necrosis factor and interleukin-6) release than ceftriaxone. These differences were not due to the antibiotic efficiency of the drugs, the species of pathogen, the dose or the time of administration, said Dr Morrison, and so imipenem may be superior for patients with sepsis. However, other factors could be involved, such as the genetic susceptibility to endotoxin and the physiological status of the patient.