Antibiotic-induced release of bacterial cell wall components in the pathogenesis of sepsis and septic shock: a review

This article reviews the new criteria for selecting the proper antimicrobia l agent and dosage regimen for standard treatment of severe sepsis, with th e intention of preventing septic shock, After introducing new concepts on t he pathogenesis of sepsis and septic shock, the authors analyze the paramet ers of betalactam antibacterial activity, the antibiotic-induced release of bacterial endotoxin and the interrelationships between pharmacokinetics an d pharmacodynamics of antibiotics in the search for an optimum dosage regim en of antimicrobial mono- or polytherapy for severely ill septic patients a dmitted to the intensive care unit.