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Title: Differential antibiotic-induced endotoxin release in severe melioidosis
Authors: A. J.H. Simpson
Steven M. Opal
B. J. Angus
J. M. Prins
J. E. Palardy
N. A. Parejo
W. Chaowagul
N. J. White
Mahidol University
Sappasitthiprasong Hospital
University of Oxford
The Warren Alpert Medical School of Brown University
Academic Medical Centre, University of Amsterdam
Memorial Hospital of Rhode Island
Keywords: Medicine
Issue Date: 19-Apr-2000
Citation: Journal of Infectious Diseases. Vol.181, No.3 (2000), 1014-1019
Abstract: Severe melioidosis is a life-threatening, systemic bacterial infection caused by Burkholderia pseudomallei. A prospective, randomized treatment trial was conducted in northeast Thailand to compare ceftazidime (a penicillin-binding protein [PBP]-3-specific agent that causes release of large amounts of endotoxin in vitro) and imipenem (a PBP-2-specific agent that kills B. pseudomallei more rapidly but releases low amounts of endotoxin) in severe melioidosis over a 6-h time course after the first dose of antibiotic. Despite similar clinical, microbiological, endotoxin, and cytokine measures at study entry, ceftazidime-treated patients (n = 34) had significantly greater systemic endotoxin (P < .001) than patients treated with imipenem (n = 34) after the first dose of antibiotic. No overall difference in mortality was observed (35% in both groups [95% confidence interval, 20%-50%]). Differential antibiotic-induced endotoxin release is demonstrable in severe melioidosis. These differences in endotoxin release did not appear to have a significant impact on survival in this group of patients.
ISSN: 00221899
Appears in Collections:Scopus 1991-2000

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