Publication: Differential antibiotic-induced endotoxin release in severe melioidosis
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Issued Date
2000-04-19
Resource Type
ISSN
00221899
DOI
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2-s2.0-0034037592
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Infectious Diseases. Vol.181, No.3 (2000), 1014-1019
Suggested Citation
A. J.H. Simpson, Steven M. Opal, B. J. Angus, J. M. Prins, J. E. Palardy, N. A. Parejo, W. Chaowagul, N. J. White Differential antibiotic-induced endotoxin release in severe melioidosis. Journal of Infectious Diseases. Vol.181, No.3 (2000), 1014-1019. doi:10.1086/315306 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/26257
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Title
Differential antibiotic-induced endotoxin release in severe melioidosis
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.