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Beneficial Antimicr...
Beneficial Antimicrobial Effect of the Addition of an Aminoglycoside to a beta-Lactam Antibiotic in an E. coli Porcine Intensive Care Severe Sepsis Model
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- Skorup, Paul (författare)
- Uppsala universitet,Infektionssjukdomar
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- Maudsdotter, Lisa (författare)
- Stockholms universitet,Institutionen för molekylär biovetenskap, Wenner-Grens institut
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- Lipcsey, Miklós (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- Castegren, Markus (författare)
- Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD)
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- Larsson, Anders (författare)
- Uppsala universitet,Biokemisk struktur och funktion
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- Jonsson, Ann-Beth (författare)
- Stockholms universitet,Institutionen för molekylär biovetenskap, Wenner-Grens institut
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- Sjölin, Jan (författare)
- Uppsala universitet,Infektionssjukdomar
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(creator_code:org_t)
- 2014-02-28
- 2014
- Engelska.
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:2, s. e90441-
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
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- This study aimed to determine whether the addition of an aminoglycoside to a beta-lactam antibiotic increases the antimicrobial effect during the early phase of Gram-negative severe sepsis/septic shock. A porcine model was selected that considered each animal's individual blood bactericidal capacity. Escherichia coli, susceptible to both antibiotics, was given to healthy pigs intravenously during 3 h. At 2 h, the animals were randomized to a 20-min infusion with either cefuroxime alone (n = 9), a combination of cefuroxime+tobramycin (n = 9), or saline (control, n = 9). Blood samples were collected hourly for cultures and quantitative polymerase chain reaction (PCR). Bacterial growth in the organs after 6 h was chosen as the primary endpoint. A blood sample was obtained at baseline before start of bacterial infusion for ex vivo investigation of the blood bactericidal capacity. At 1 h after the administration of the antibiotics, a second blood sample was taken for ex vivo investigation of the antibiotic-induced blood killing activity. All animals developed severe sepsis/septic shock. Blood cultures and PCR rapidly became negative after completed bacterial infusion. Antibiotic-induced blood killing activity was significantly greater in the combination group than in the cefuroxime group (p < 0.001). Growth of bacteria in the spleen was reduced in the two antibiotic groups compared with the controls (p < 0.01); no difference was noted between the two antibiotic groups. Bacterial growth in the liver was significantly less in the combination group than in the cefuroxime group (p < 0.05). High blood bactericidal capacity at baseline was associated with decreased growth in the blood and spleen (p < 0.05). The addition of tobramycin to cefuroxime results in increased antibiotic-induced blood killing activity and less bacteria in the liver than cefuroxime alone. Individual blood bactericidal capacity may have a significant effect on antimicrobial outcome.
Ämnesord
- NATURVETENSKAP -- Biologi (hsv//swe)
- NATURAL SCIENCES -- Biological Sciences (hsv//eng)
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- art (ämneskategori)
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