Abstract
Polymyxin B (PMB) is a surface-active agent and antibiotic which ameliorates the adverse effects of endotoxin. Sodium deoxycholate (NaD), a surface-active agent present in bile, also protects against endotoxin. To determine if either of these agents is efficacious in Gram-negative bacterial sepsis compared to antibiotics alone, 36 New Zealand White rabbits were infected by intraperitoneal injection of mucin-enhanced E. coli K1. One hour after infection all animals were treated with moxalactara, 100 mg/kg, and were then randomized in groups of three to receive either saline, PMB 0.21 mg/kg/hr, or NaD 1.0 mg/kg/hr. Blood was sampled prior to infection and hourly thereafter and assayed for bacterial colony-forming units, plasma endotoxin, arterial blood gases and complete blood counts. Heart rate, mean arterial blood pressure (MAP), and core body temperature were monitored continuously. Although levels of bacteremia and endotoxemia were similar in all three groups, the PMB group had significantly higher MAP, pH, and bicarbonate concentrations than the control group (p<0.05). Rabbits receiving NaD fared no better than controls. This work shows that PMB effectively blocks some of the physiologic responses to endotoxin and provides support for a clinical trial of PMB in patients with overwhelming Gram-negative sepsis.
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Flynn, P., Shenep, J. & Stokes, D. POLYMYXIN B AS ADJUVANT THERAPY FOR OVERWHELMING GRAM-NEGATIVE BACTERIAL SEPSIS. Pediatr Res 21 (Suppl 4), 324 (1987). https://doi.org/10.1203/00006450-198704010-00943
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DOI: https://doi.org/10.1203/00006450-198704010-00943