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Increasing antibiotic dose decreases polymicrobial infection after hemorrhagic shock
D H Livingston1, M A Malangoni
1Department of Surgery, University of Louisville.
Surgery, Gynecology & Obstetrics
|May 1, 1993
Summary
Hemorrhagic shock increases infection risk. Higher cefoxitin doses effectively treated mixed gram-negative infections post-shock, unlike standard doses, suggesting altered antibiotic strategies may improve outcomes.
Area of Science:
- Infectious Diseases
- Pharmacology
- Trauma Surgery
Background:
- Hemorrhagic shock compromises the immune system, increasing infection susceptibility.
- Conventional antibiotic doses may be insufficient to combat infections following hemorrhagic shock.
Purpose of the Study:
- To evaluate the efficacy of increased cefoxitin dosing in treating mixed gram-negative infections in a rat model of hemorrhagic shock.
- To compare the effectiveness of standard versus high-dose cefoxitin in controlling infection with and without induced shock.
Main Methods:
- Hemorrhagic shock was induced in rats by bleeding, followed by resuscitation.
- Rats were inoculated with Escherichia coli and Bacteroides fragilis.
- Animals received no antibiotic, standard-dose cefoxitin, or high-dose cefoxitin at specific intervals.
Main Results:
- Standard cefoxitin dose showed reduced efficacy in shock models compared to non-shocked models.
- High-dose cefoxitin significantly decreased abscess size and weight post-shock compared to standard dose.
- Peak tissue cefoxitin concentrations with high-dose were significantly higher than with standard-dose.
Conclusions:
- Increased cefoxitin dosage is superior to conventional dosing for treating mixed gram-negative infections after hemorrhagic shock.
- Altering traditional antibiotic dosing regimens may be crucial for reducing infection incidence post-hemorrhage and shock.