Antibiotics, cytokines, and endotoxin: a complex and evolving

Scand J Infect Dis Suppl · Jan 1996

Review

Antibiotics, cytokines, and endotoxin: a complex and evolving relationship in gram-negative sepsis.

Compelling experimental evidence now exists that antimicrobial agents induce the release of endotoxin from Gram-negative bacteria during the process of bacteriolysis. Different antimicrobial classes, particularly those which act upon the outer membrane of bacteria, vary in the amount of free endotoxin released from Gram-negative organisms. ⋯ Complexities in the host-pathogen interactions during actual infection with Gram-negative bacteria may account for the difficulties in demonstrating this phenomena in vivo. This brief review analyses these interactions and defines clinical settings where antibiotic-induced endotoxin release may prove to be clinically relevant.

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- D L Horn, S M Opal, and E Lomastro.
- Merck US Human Health, West Point, PA, USA.
- Scand J Infect Dis Suppl. 1996 Jan 1;101:9-13.
AbstractCompelling experimental evidence now exists that antimicrobial agents induce the release of endotoxin from Gram-negative bacteria during the process of bacteriolysis. Different antimicrobial classes, particularly those which act upon the outer membrane of bacteria, vary in the amount of free endotoxin released from Gram-negative organisms. Despite this in vitro evidence, clinically important consequences of antibiotic-induced endotoxin release have yet to be consistently documented. Complexities in the host-pathogen interactions during actual infection with Gram-negative bacteria may account for the difficulties in demonstrating this phenomena in vivo. This brief review analyses these interactions and defines clinical settings where antibiotic-induced endotoxin release may prove to be clinically relevant.

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Antibiotics, cytokines, and endotoxin: a complex and evolving relationship in gram-negative sepsis.

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