Friedland I R, Jafari H, Ehrett S, Rinderknecht S, Paris M, Coulthard M, Saxen H, Olsen K, McCracken G H
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75235-9063.
J Infect Dis. 1993 Sep;168(3):657-62. doi: 10.1093/infdis/168.3.657.
In a rabbit Escherichia coli meningitis model, endotoxin liberation and concentrations of leukocytes, tumor necrosis factor (TNF), and lactate were compared after a single intravenous dose of cefotaxime, cefpirome, meropenem, chloramphenicol, or gentamicin. These antibiotics caused a 2- to 10-fold increase in cerebrospinal fluid concentrations of free (filterable) endotoxin within 2 h of starting treatment. By contrast, free endotoxin concentrations increased almost 100-fold in untreated animals 4 h later as bacteria continued to multiply. An initial enhancement of inflammation in the central nervous system occurred in all treatment groups compared with untreated controls. No significant differences were observed between treatment groups except for lower TNF concentrations in chloramphenicol-treated animals. Antibiotic therapy in E. coli meningitis, irrespective of the agent used, may result in an increase in free endotoxin and enhancement of inflammation, but the amount of endotoxin liberated is considerably smaller than that shed by untreated bacteria.
在兔大肠杆菌脑膜炎模型中，比较了单次静脉注射头孢噻肟、头孢匹罗、美罗培南、氯霉素或庆大霉素后内毒素释放以及白细胞、肿瘤坏死因子（TNF）和乳酸的浓度。这些抗生素在开始治疗后2小时内使脑脊液中游离（可滤过）内毒素浓度增加了2至10倍。相比之下，4小时后未治疗的动物体内游离内毒素浓度增加了近100倍，因为细菌持续繁殖。与未治疗的对照组相比，所有治疗组中枢神经系统的炎症最初均有增强。除氯霉素治疗的动物中TNF浓度较低外，各治疗组之间未观察到显著差异。在大肠杆菌脑膜炎中进行抗生素治疗，无论使用何种药物，都可能导致游离内毒素增加和炎症增强，但释放的内毒素量比未治疗的细菌释放的量要小得多。
