Antibiotic induced release of endotoxin - clinical data and human studies

Abstract

In vitro and animal studies, but also clinical data, indicate that treatment with antibiotics may cause systemic or local endotoxin liberation. In several studies this so-called 'endotoxin release' was accompanied by a deterioration of parameters of illness. In addition, in vitro studies have clearly demonstrated that equally effective antibiotics can differ in the amount of endotoxin they release. These differences between antibiotics can be related to different modes of anti-bacterial activities. In a number of animal studies these differences in endotoxin-releasing potential resulted in differences in morbidity and/or mortality. In only one study, antibiotics were compared in this respect in septic patients. The results of that study suggested that differences between antibiotics in endotoxin release may indeed affect the inflammatory response during treatment.