AI Article Synopsis
- The mortality rate from severe bacterial sepsis is still around 50% despite good treatment options, due to complex factors like bacterial endotoxins.
- Antimicrobial therapy can sometimes worsen sepsis by releasing these toxins, influenced by the type of antibiotics used, rather than the specific bacteria.
- Certain antibiotics, including carbapenems and glycopeptides, are less likely to trigger septic shock because they effectively kill bacteria quickly, leading to less harmful bacterial forms.
Article Abstract
The mortality rate resulting from severe bacterial sepsis, particularly that associated with shock, still approaches 50% in spite of appropriate antimicrobial therapy and optimum supportive care. Bacterial endotoxins that are part of the cell wall are one of the cofactors in the pathogenesis of sepsis and septic shock and are often induced by antimicrobial chemotherapy even if it is administered rationally. Not all antimicrobial agents are equally capable of inducing septic shock; this is dependant on their mechanism of action rather than on the causative pathogen species. The quantity of endotoxin released depends on the drug dose and whether filaments or spheroplast formation predominates. Some antibiotics such as carbapenems, ceftriaxone, cefepime, glycopeptides, aminoglycosides and quinolones do not have the propensity to provoke septic shock because their rapid bactericidal activity induces mainly spheroplast or fragile spheroplast-like bacterial forms.
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| http://dx.doi.org/10.1016/s0924-8579(99)00044-8 | DOI Listing |
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