Antibiotics and energy delivery to the phagocytosis-associated respiratory burst in chronic hemodialysis patients: a comparison of cefodizime and cotrimoxazole.
Twenty-three stabilized chronic uremic patients with no active or recent infection were treated for 10 days with either cefodizime (5 x 2 g intravenously, n = 10) or cotrimoxazole (960 mg orally b.i.d., n = 8) in order to evaluate the effects on the depressed polymorphonuclear metabolic response to phagocytic challenge; a separate group of 5 patients received placebo. Ex vivo evaluation in whole blood of energy delivery to the phagocytosis-associated respiratory burst activity in response to latex and zymosan challenge was determined by measuring hexose-monophosphate shunt NAD(P)H-oxidase-related glycolytic activity. Cefodizime induced a statistically significant increase in the baseline-depressed glycolytic response for both latex and zymosan challenge, in contrast to cotrimoxazole and placebo. Depressed phagocytosis-related metabolic function in hemodialyzed patients was stimulated by cefodizime in recommended therapeutic doses but not by cotrimoxazole, the effect persisting for at least 2 weeks after the end of treatment.
Vanholder
R
R
Nephrology Department, University Hospital, Ghent, Belgium.
Dagrosa
E E
EE
Van Landschoot
N
N
Waterloos
M A
MA
Ringoir
S M
SM
D000328:Adult; D000368:Aged; D002439:Cefotaxime / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004734:Energy Metabolism / Q000187:drug effects / Q000502:physiology; D005260:Female; D006019:Glycolysis / Q000502:physiology; D006801:Humans; D007275:Injections, Intravenous; D007840:Latex / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009247:NADH, NADPH Oxidoreductases / Q000502:physiology; D019255:NADPH Oxidases; D009504:Neutrophils / Q000378:metabolism; D010586:Phagocytes / Q000378:metabolism; D010587:Phagocytosis / Q000187:drug effects / Q000502:physiology*; D006435:Renal Dialysis; D016897:Respiratory Burst / Q000187:drug effects / Q000502:physiology*; D013997:Time Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D014511:Uremia / Q000503:physiopathology* / Q000628:therapy*; D015054:Zymosan / Q000494:pharmacology
D007840:Latex; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D015054:Zymosan; D009247:NADH, NADPH Oxidoreductases; D019255:NADPH Oxidases; D002439:Cefotaxime; C033356:cefodizime