CIRCULATING ENDOTOXIN DURING INITIAL ANTIBIOTIC-TREATMENT OF SEVERE GRAM-NEGATIVE BACTEREMIC INFECTIONS

The impact of antibiotics on total endotoxemia and circulating tumor n ecrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-8 in 18 patient s with severe bacteremic sepsis or septic shock due to gram-negative s pecies was investigated. Endotoxemia, TNF-alpha, IL-6, and IL-8 were a ssayed before (H0) and 1 h (H1) and 4 h (H4) after the first antibioti c infusion. Endotoxemia decreased from H0 (median, 0.4 EU/mL; interqua rtile interval, 0.09-1.23) to H1 (median, 0.19 EU/mL; interquartile in terval, 0.07-0.75; P = .03) and remained stable between H1 and H4 (med ian, 0.12 EU/mL; interquartile interval, 0.09-0.30; P = .4), IL-6 leve ls fell between H0 and H4 (P = .01) and between H1 and H4 (P = .03). I L-8 was higher at H0 than at H1 (P = .04) and at H4 (P = .01). These r esults suggest that endotoxemia is not increased by antibiotherapy of severe gram-negative bacteremia.