ANTIBIOTICS IN SEPSIS INITIATION

Stephen Jackson, University of Wales, speaking at a Bayer-sponsored conference, said that antibiotics may be increasing the rate of Gram-negative sepsis, for which endotoxin is the primary trigger. He went on to say that the class and mode of action of the antibiotic was crucial as the rate of endotoxin release was not necessarily linked to rapid bacterial killing. It appears instead to be closely related to inhibition of penicillin-binding protein III, which varies depending on the antibiotic. In a comparison of cefotaxime, gentamicin, imipenem and ciprofloxacin in an E coli rat model, he said, ciprofloxacin was shown to release the least endotoxins, while still killing the organism.