Inadequate timing between corticosteroid and antibiotic applications increases mortality due to sepsis

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dc.contributor.authorFadel M.V.T.
dc.contributor.authorRepka J.C.
dc.contributor.authorda Cunha C.L.P.
dc.contributor.authorLeao M.T.C.
dc.date.accessioned2024-03-13T01:36:41Z
dc.date.available2024-03-13T01:36:41Z
dc.date.issued2008
dc.description.abstractThis study tested the hypothesis that the use of corticosteroids prior to antibiotics can lower the mortality rate in severe infections by S. aureus or Gram-negative bacilli, using an animal model. This study was a prospective and controlled study, placed in a university laboratory. Seven hundred and sixty mice distributed into three groups (Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae infected). The interventions in each group were: I) infection control (intra-peritoneal); II) treatment solely with antibiotics (teicoplanin or amikacin); III) antibiotics administered prior to the corticosteroid (methylprednisolone); IV) antibiotics administered after the corticosteroid. Mortality in the E. coli group, subgroup I: 100%; subgroup II: 55% (p<0.001); subgroup III: 62.5% (p=0.2488, compared to subgroup II); subgroup IV: 20% (p<0.01 compared to subgroups II and III). Mortality in the K. pneumoniae group: subgroup I: 100%; subgroup II: 72.5% (p<0.01); subgroup III: 80% (p=0.215 compared to subgroup II); subgroup IV: 45% (p<0.01 compared to subgroups II and III). Mortality in the S. aureus group: subgroup I: 82.5%; II: 42.5% (p<0.001); subgroup III: 77.5% (p=0.2877 compared to subgroup I); subgroup IV: 32.5% (p=0.1792 compared to subgroup II). The use of corticosteroids prior to antibiotics lowered the mortality rate caused by Gram-negative bacteria and did not affect the mortality caused by S. aureus. When used after starting treatment with antibiotics, the corticosteroid was not superior to the use of antibiotics alone in the case of the Gram-negative bacteria, and was not significantly different from non-treatment of the infection, in the case of S. aureus. © 2008 by The Brazilian Journal of Infectious Diseases and Contexto Publishing. All rights reserved.
dc.description.firstpage416
dc.description.issuenumber5
dc.description.lastpage422
dc.description.volume12
dc.identifier.issn1413-8670
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/37472
dc.relation.ispartofBrazilian Journal of Infectious Diseases
dc.rightsAcesso Restrito
dc.subject.otherlanguageAdrenal cortex hormones
dc.subject.otherlanguageAnimals
dc.subject.otherlanguageAntibiotics
dc.subject.otherlanguageEndotoxin
dc.subject.otherlanguageLaboratory
dc.subject.otherlanguageMice
dc.subject.otherlanguagePeritonitis
dc.subject.otherlanguageSepsis
dc.subject.otherlanguageSevere infection
dc.subject.otherlanguageShock
dc.subject.otherlanguageSurvival
dc.titleInadequate timing between corticosteroid and antibiotic applications increases mortality due to sepsis
dc.typeArtigo
local.scopus.citations5
local.scopus.eid2-s2.0-65449159825
local.scopus.updated2024-05-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=65449159825&origin=inward
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