Antibiotics improve survival and alter the inflammatory profile in a murine model of sepsis from Pseudomonas aeruginosa pneumonia

Shock. 2003 May;19(5):408-14. doi: 10.1097/01.shk.0000054370.24363.ee.

Abstract

Differing antibiotic regimens can influence both survival and the inflammatory state in sepsis. We investigated whether the addition and/or type of antimicrobial agent could effect mortality in a murine model of Pseudomonas aeruginosa pneumonia-induced sepsis and if antibiotics altered systemic levels of cytokines. FVB/N mice were subjected to intratracheal injection of pathogenic bacteria and were given gentamicin, imipenem, or 0.9% NaCl 2 h after surgery, which continued every 12 h for a total of six doses. Survival at 7 days (n = 24 in each group) was 100% for mice given gentamicin, 88% for mice given imipenem, and 8% for sham mice treated with 0.9% NaCl (P < 0.0001). Systemic interleukin (IL) 6 levels were assayed 6 h postoperatively on all mice to see if they were predictive of outcome. Plasma IL-6 levels above 3,600 pg/mL were associated with a 100% mortality, levels under 1,200 pg/mL were associated with a 100% survival, and levels between 1,200 and 3,600 pg/mL had no utility in predicting mortality. In a separate experiment, mice were sacrificed at 3, 6, 12 or 24 h after instillation of P. aeruginosa and were assayed for levels of TNF-alpha, IL-6, IL-10, and IL-12. Significant alterations in the proinflammatory cytokines TNF-alpha and IL-6 were present at all time points except 3 h between mice treated with antibiotics and sham controls. In contrast, statistically significant differences in the anti-inflammatory cytokine IL-10 were present between the groups only at 6 h, and levels of IL-12 were similar at all time points. These results indicate that both gentamicin and imipenem increase survival at least 10-fold in a model of pneumonia-induced monomicrobial sepsis, and this is predominantly associated with a down-regulation of proinflammatory cytokines.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use*
  • Biomarkers / blood
  • Cytokines / blood
  • Disease Models, Animal
  • Gentamicins / therapeutic use
  • Imipenem / therapeutic use
  • Interleukin-6 / blood
  • Lipopolysaccharides / toxicity
  • Mice
  • Mice, Inbred Strains
  • Pneumonia, Bacterial / blood
  • Pneumonia, Bacterial / complications*
  • Pseudomonas Infections / blood
  • Pseudomonas Infections / complications*
  • Pseudomonas aeruginosa*
  • Sepsis / blood
  • Sepsis / drug therapy*
  • Sepsis / immunology
  • Survival Analysis
  • Time Factors

Substances

  • Anti-Bacterial Agents
  • Biomarkers
  • Cytokines
  • Gentamicins
  • Interleukin-6
  • Lipopolysaccharides
  • Imipenem