Peri-Operative Antimicrobial Prophylaxis Modulates CD4⁺ Lymphocyte Immunophenotype Ex Vivo in High-Risk Patients...

Area of Science:

• Immunology
• Pharmacology
• Surgical Oncology

Background:

• Post-operative infections are a significant complication following major elective surgery.
• Peri-operative antibiotics are administered to mitigate infection risk.
• Certain antibiotics possess immunomodulatory properties influencing host immune responses.

Purpose of the Study:

• To investigate the ex vivo immunomodulatory effects of common antibiotics on monocyte and lymphocyte phenotypes.
• To assess the impact of amoxicillin, cefuroxime, metronidazole, and cefuroxime-metronidazole on immune cells post-major elective surgery.

Main Methods:

• Prospective cohort study involving adult patients undergoing major elective non-cardiac surgery.
• Isolation of peripheral blood mononuclear cells immediately after surgery.
• Ex vivo incubation of cells with antibiotics and specific immune stimuli, followed by flow cytometry analysis.

Main Results:

• All tested antibiotics reduced T-cell viability; monocyte changes were minimal.
• Cefuroxime increased IFN-γ, IL-2, and IL-2R in CD4+ and CD8+ lymphocytes.
• Cefuroxime shifted CD4+ lymphocytes towards a Th1 phenotype, decreasing Th2 and Th17 populations.

Conclusions:

• Antibiotic selection influences immune function after major surgery.
• Cefuroxime exhibits ex vivo immunomodulatory effects on CD4+ lymphocytes.
• Further research is needed to understand the clinical implications on post-operative infections and cancer survival.