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- Title
Differential antibiotic-induced endotoxin release in severe melioidosis.
- Authors
Simpson, A J; Opal, S M; Angus, B J; Prins, J M; Palardy, J E; Parejo, N A; Chaowagul, W; White, N J
- 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.
- Publication
The Journal of infectious diseases, 2000, Vol 181, Issue 3, p1014
- ISSN
0022-1899
- Publication type
Journal Article
- DOI
10.1086/315306