Antibiotics, cytokines, and endotoxin: a complex and evolving relationship in gram-negative sepsis.
Compelling experimental evidence now exists that antimicrobial agents induce the release of endotoxin from Gram-negative bacteria during the process of bacteriolysis. Different antimicrobial classes, particularly those which act upon the outer membrane of bacteria, vary in the amount of free endotoxin released from Gram-negative organisms. Despite this in vitro evidence, clinically important consequences of antibiotic-induced endotoxin release have yet to be consistently documented. Complexities in the host-pathogen interactions during actual infection with Gram-negative bacteria may account for the difficulties in demonstrating this phenomena in vivo. This brief review analyses these interactions and defines clinical settings where antibiotic-induced endotoxin release may prove to be clinically relevant.
Horn
D L
DL
Merck US Human Health, West Point, PA, USA.
Opal
S M
SM
Lomastro
E
E
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016207:Cytokines / Q000502:physiology*; D004731:Endotoxins / Q000378:metabolism*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D018805:Sepsis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D016207:Cytokines; D004731:Endotoxins