Antibiotics delay but do not prevent bacteremia and lung injury in murine sepsis.
OBJECTIVE
To investigate the effect of antibiotics on infection, lung injury, and mortality rate in polymicrobial sepsis and to determine whether an association exists between infection and lung injury and mortality rate. To circumvent the effect of antibiotics on cultures, we used polymerase chain reaction to detect bacteria.


METHODS
Prospective, randomized, controlled laboratory trial.


METHODS
University research laboratory.


METHODS
C57/BL6 mice.


METHODS
Mice underwent cecal ligation and puncture without antibiotics (CLP) or with imipenem (CLP + Abx).


RESULTS
CLP resulted in 50% mortality rate at 48 hrs and 100% mortality rate at 84 hrs. Antibiotics delayed these time points to 72 and 120 hrs, respectively. Lung injury occurred before mortality in both groups. Polymerase chain reaction detected bacteria in the blood and lungs of all CLP mice by 24 hrs. Antibiotics delayed but did not prevent infection in CLP + Abx mice. Serum tumor necrosis factor-alpha and lung endotoxin were elevated to similar concentrations in both CLP and CLP + Abx mice.


CONCLUSIONS
In this model of sepsis, antibiotics delay but do not prevent acute lung injury and mortality. Even in the presence of antibiotics, acute lung injury is strongly associated with bacteremia and bacteria within the lungs.
Doerschug
Kevin C
KC
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA, USA.
Powers
Linda S
LS
Monick
Martha M
MM
Thorne
Peter S
PS
Hunninghake
Gary W
GW
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D015378:Imipenem / Q000627:therapeutic use*; D051379:Mice; D008810:Mice, Inbred C57BL; D011446:Prospective Studies; D011897:Random Allocation; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000209:etiology; D018805:Sepsis / Q000150:complications*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D015378:Imipenem