Document Detail

Clinical implications of antibiotic-induced endotoxin release in septic shock.
MedLine Citation:
PMID:  12122518     Owner:  NLM     Status:  MEDLINE    
Antibiotic-induced release of bacterial cell wall components can have immediate adverse effects for the patient. This article reviews the data on endotoxin release after initiation of antibiotic therapy and its role in the pathogenesis of sepsis and septic shock. Antibiotics differ in their potential to liberate endotoxins from bacterial cell walls. When used for treatment of systemic Gram-negative infection, some classes of beta-lactam antibiotics lead to markedly increased levels of free endotoxins while treatment with carbapenems and aminoglycosides produces relatively low amounts of endotoxins. Antibiotics that induce the formation of long, aberrant bacterial cells before effectively killing the microorganisms show the highest degree of endotoxin liberation. There is increasing evidence from animal models and clinical studies of sepsis that the antibiotic-mediated release of biologically active cell wall components derived from Gram-positive, Gram-negative or fungal organisms is associated with a rapid clinical deterioration.
P M Lepper; T K Held; E M Schneider; E Bölke; H Gerlach; M Trautmann
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Publication Detail:
Type:  Journal Article; Review     Date:  2002-05-30
Journal Detail:
Title:  Intensive care medicine     Volume:  28     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-17     Completed Date:  2002-11-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  824-33     Citation Subset:  IM    
Dept. of Medical Microbiology and Hygiene, University Hospital, Steinhövelstr. 9, 89075 Ulm, Germany.
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MeSH Terms
Anti-Bacterial Agents / adverse effects*,  therapeutic use
Body Fluids / metabolism
Gram-Negative Bacteria / metabolism
Gram-Negative Bacterial Infections / chemically induced,  drug therapy*,  metabolism
Lipopolysaccharides / metabolism*
Shock, Septic / complications,  drug therapy*,  metabolism
Treatment Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Lactams; 0/Lipopolysaccharides

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