Department of Anesthesiology, University Medical Center, Johannes Gutenberg-University Mainz, Langenbeckstraße 1 (Bld. 505), Mainz, 55131, Germany.
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
BMC Neurosci. 2024 Feb 29;25(1):10. doi: 10.1186/s12868-024-00851-6.
TBI is a leading cause of death and disability in young people and older adults worldwide. There is no gold standard treatment for TBI besides surgical interventions and symptomatic relief. Post-injury infections, such as lower respiratory tract and surgical site infections or meningitis are frequent complications following TBI. Whether the use of preventive and/or symptomatic antibiotic therapy improves patient mortality and outcome is an ongoing matter of debate. In contrast, results from animal models of TBI suggest translational perspectives and support the hypothesis that antibiotics, independent of their anti-microbial activity, alleviate secondary injury and improve neurological outcomes. These beneficial effects were largely attributed to the inhibition of neuroinflammation and neuronal cell death. In this review, we briefly outline current treatment options, including antibiotic therapy, for patients with TBI. We then summarize the therapeutic effects of the most commonly tested antibiotics in TBI animal models, highlight studies identifying molecular targets of antibiotics, and discuss similarities and differences in their mechanistic modes of action.
TBI 是全球年轻人和老年人死亡和残疾的主要原因。除了手术干预和对症治疗外，TBI 没有标准的治疗方法。受伤后的感染，如下呼吸道和手术部位感染或脑膜炎，是 TBI 后的常见并发症。预防性和/或对症使用抗生素治疗是否能提高患者的死亡率和预后，这是一个持续存在的争议问题。相比之下，TBI 动物模型的结果表明了转化的观点，并支持了这样一种假设，即抗生素具有减轻继发性损伤和改善神经功能预后的作用，而与抗生素的抗微生物活性无关。这些有益的作用主要归因于抑制神经炎症和神经元细胞死亡。在这篇综述中，我们简要概述了 TBI 患者的当前治疗选择，包括抗生素治疗。然后，我们总结了最常用于 TBI 动物模型的抗生素的治疗效果，强调了确定抗生素分子靶点的研究，并讨论了它们在作用机制方面的异同。
