Polymyxin B moderates acidosis and hypotension in established, experimental gram-negative septicemia.
Polymyxin B (PMB), an antibiotic, and sodium deoxycholate (NaD), a bile salt, are surface-active agents. Each protected mice against an otherwise lethal challenge with purified endotoxin (P less than .001). To determine if either of these agents was effective in treating established, overwhelming gram-negative septicemia, we infected rabbits by intraperitoneal injection of Escherichia coli K1. Animals were treated with moxalactam 1 hr after infection, then randomly assigned to groups receiving either saline, PMB, or NaD. Serial samples of blood were assayed for bacterial concentration, levels of plasma endotoxin, arterial blood gases, and complete blood cell counts. Physiologic functions were monitored continuously. Although levels of bacteremia and endotoxemia were similar in all three groups, rabbits receiving PMB had significantly higher mean arterial blood pressure, blood pH, and bicarbonate concentrations than did control rabbits (P less than .05). Rabbits receiving NaD fared no better than controls. In this model, PMB moderates some of the deleterious effects of established, overwhelming gram-negative bacterial sepsis.
Flynn
P M
PM
Division of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee 38101.
Shenep
J L
JL
Stokes
D C
DC
Fairclough
D
D
Hildner
W K
WK
D000138:Acidosis / Q000209:etiology / Q000503:physiopathology*; D000818:Animals; D002245:Carbon Dioxide / Q000097:blood; D003840:Deoxycholic Acid / Q000627:therapeutic use; D004731:Endotoxins / Q000097:blood; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D006863:Hydrogen-Ion Concentration; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology*; D007958:Leukocyte Count; D051379:Mice; D010100:Oxygen / Q000097:blood; D010976:Platelet Count; D011112:Polymyxin B / Q000627:therapeutic use*; D011113:Polymyxins / Q000627:therapeutic use*; D011817:Rabbits; D018805:Sepsis / Q000097:blood / Q000150:complications / Q000188:drug therapy*
D004731:Endotoxins; D011113:Polymyxins; D003840:Deoxycholic Acid; D002245:Carbon Dioxide; D011112:Polymyxin B; D010100:Oxygen