ArticleCritical care medicine2012
Bactericidal antibiotics temporarily increase inflammation and worsen acute kidney injury in experimental sepsis.
Article in Critical care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- The Impact of Timing of Antibiotics on Outcomes in Severe Sepsis and Septic Shock: A Systematic Review and Meta-Analysis.Critical care medicine · 2015Pooled it
- Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteria.Renal failure · 2025Article
- Galectin-3 Mediates Endotoxin Internalization and Caspase-4/11 Activation in Tubular Epithelials and Macrophages During Sepsis and Sepsis-Associated Acute Kidney Injury.Inflammation · 2024Article
- Cathelicidin-HG Alleviates Sepsis-Induced Platelet Dysfunction by Inhibiting GPVI-Mediated Platelet Activation.Research (Washington, D.C.) · 2024Article
- The Novel Compound SUL-138 Counteracts Endothelial Cell and Kidney Dysfunction in Sepsis by Preserving Mitochondrial Function.International journal of molecular sciences · 2023Article
- Galectin-3 in septic acute kidney injury: a translational study.Critical care (London, England) · 2021Observational
- Clinical physiology aspects of chloremia in fluid therapy: a systematic review.Perioperative medicine (London, England) · 2020Review
- Csf2 Attenuated Sepsis-Induced Acute Kidney Injury by Promoting Alternative Macrophage Transition.Frontiers in immunology · 2020Article
- Towards Inhaled Phage Therapy in Western Europe.Viruses · 2019Review
- Renal Tubular Cell Mitochondrial Dysfunction Occurs Despite Preserved Renal Oxygen Delivery in Experimental Septic Acute Kidney Injury.Critical care medicine · 2018Article
- Hyperchloraemia in sepsis.Annals of intensive care · 2018Review
- Sequential Analysis of a Panel of Biomarkers and Pathologic Findings in a Resuscitated Rat Model of Sepsis and Recovery.Critical care medicine · 2017Article
- Cyclic PaOBMC anesthesiology · 2017Article
- Acute kidney injury and inflammatory response of sepsis following cecal ligation and puncture in d-galactose-induced aging rats.Clinical interventions in aging · 2017Article
- Cross-species validation of cell cycle arrest markers for acute kidney injury in the rat during sepsis.Intensive care medicine experimental · 2016Article
- Update on sepsis-associated acute kidney injury: emerging targeted therapies.Biologics : targets & therapy · 2016Review
- Why do they die? Comparison of selected aspects of organ injury and dysfunction in mice surviving and dying in acute abdominal sepsis.Intensive care medicine experimental · 2015Article
- Inflammatory mediators in intra-abdominal sepsis or injury - a scoping review.Critical care (London, England) · 2015Article
- [Lung and kidney failure. Pathogenesis, interactions, and therapy].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2015Review
- Effects of hemoadsorption with a novel adsorbent on sepsis: in vivo and in vitro study.Blood purification · 2015Article
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Authors and funding
9 authors at 2 institutions in 3 countries.
Funding
Abstract
objectiveTo explore the relationships among bactericidal antimicrobial treatment of sepsis, inflammatory response, severity of acute kidney injury, and outcomes.
designControlled laboratory experiment.
settingUniversity laboratory.
interventionsSepsis was induced by cecal ligation and puncture in 52 rats and was treated with either bactericidal antibiotics (ampicillin/sulbactam) or placebo (saline). Serial blood specimens were obtained after cecal ligation and puncture for serum creatinine, interleukin-6, and neutrophil gelatinase-associated lipocalin concentrations. RIFLE (Risk, Injury, Failure, Loss, End-stage kidney disease) criteria were used to assess severity of acute kidney injury. All animals were observed for survival up to 1 wk. In a separate experiment, six healthy animals were given antibiotics and renal function was assessed. Another 12 animals were euthanized 2 days after laparotomy for kidney histology. MEASUREMENTS AND MAIN
resultsSurvival in the placebo group was 50% compared with 81.8% in the antibiotic group (p < .05). Most animals (93%) without antibiotics developed acute kidney injury, of which 39% exhibited greater than a threefold rise in serum creatinine (RIFLE-F). Furthermore, survival decreased as acute kidney injury severity increased. Surprisingly, all antibiotic-treated animals developed acute kidney injury, of which 68.6% reached RIFLE-F. However, renal dysfunction was less persistent in these animals. Patterns of plasma interleukin-6 were similar to creatinine with higher concentrations seen earlier in antibiotic-treated animals but with faster resolution. Interleukin-6 concentration at 24 hrs was independently associated with the development of RIFLE-F. Histologic findings were consistent with functional parameters showing that antibiotics worsened acute kidney injury.
conclusionIn polymicrobial sepsis, bactericidal antibiotics resulted in more inflammation and more severe acute kidney injury. However, resolution of inflammation and acute kidney injury was faster with antibiotics and correlated best with survival. These results suggest that transient worsening of renal function may be an expected consequence of sepsis therapy. These findings also question the value of peak severity of acute kidney injury as a primary end point and suggest that resolution of acute kidney injury may be more appropriate.
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