title: [Is monotherapy with β-lactam antibiotics still up to date? New aspects for treatment of severe infections].
abstract: Mortality of sepsis is still high. Crucial for therapeutic response are the early start of treatment as well as the choice of antibiotics or antibiotic combinations. β-lactam antibiotics with bactericidal mode of action are often recommended in guidelines. But this antibiotic class can trigger the immune system to a maximum by releasing cell wall components or exotoxins. This may lead to a worsening of the patient's clinical situation. In contrast, antibiotics with bacteriostatic action often inhibit bacterial protein synthesis with decrease of production of virulence factors and minimize release of cell wall components. The purpose of this review is to summarise the significance of some bacteriostatic antibiotics and to discuss whether a combination of bactericidal and bacteriostatic agents may improve the course of the illness.
authors.affiliation: Innere Medizin, Klinik St.Wolfgang, Bad Griesbach, Germany. p.heizmann@asklepios.com
authors.forename: P
authors.initials: P
authors.lastname: Heizmann
authors.forename: H
authors.initials: H
authors.lastname: Lode
authors.forename: W R
authors.initials: WR
authors.lastname: Heizmann
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects / Q000276:immunology; D001424:Bacterial Infections / Q000188:drug therapy* / Q000276:immunology; D002473:Cell Wall / Q000187:drug effects / Q000276:immunology; D003422:Critical Care; D003428:Cross Infection / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005098:Exotoxins / Q000097:blood; D019983:Guideline Adherence; D006801:Humans; D007114:Immunization; D016209:Interleukin-8 / Q000097:blood; D018805:Sepsis / Q000188:drug therapy* / Q000276:immunology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000276:immunology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000276:immunology; D037521:Virulence Factors / Q000037:antagonists & inhibitors; D047090:beta-Lactams / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D005098:Exotoxins; D016209:Interleukin-8; D037521:Virulence Factors; D047090:beta-Lactams