Effect of a single dose of tobramycin on systemic inflammatory response-induced acute kidney injury in a 6-hour porcine model*
(2009) In Critical Care Medicine 37(10). p.2782-2790- Abstract
- OBJECTIVE:: To evaluate whether the addition of tobramycin further compromises renal function in inflammatory response-induced acute kidney injury. Effective antibiotic treatment in septic shock is crucial for the outcome. The combination of aminoglycosides with different beta-lactam antibiotics offers a broad antimicrobial coverage, rapid bacterial killing, synergistic effects, and low antibiotic-induced endotoxin release. However, aminoglycosides have nephrotoxic effects that may aggravate sepsis-induced acute kidney injury. DESIGN:: Prospective, randomized, placebo-controlled experimental study. SETTING:: University research unit. SUBJECTS:: Twenty-four healthy pigs. INTERVENTIONS:: The animals were anesthetized and randomized to four... (More)
- OBJECTIVE:: To evaluate whether the addition of tobramycin further compromises renal function in inflammatory response-induced acute kidney injury. Effective antibiotic treatment in septic shock is crucial for the outcome. The combination of aminoglycosides with different beta-lactam antibiotics offers a broad antimicrobial coverage, rapid bacterial killing, synergistic effects, and low antibiotic-induced endotoxin release. However, aminoglycosides have nephrotoxic effects that may aggravate sepsis-induced acute kidney injury. DESIGN:: Prospective, randomized, placebo-controlled experimental study. SETTING:: University research unit. SUBJECTS:: Twenty-four healthy pigs. INTERVENTIONS:: The animals were anesthetized and randomized to four groups. Groups I (n = 8) and II (n = 8) received endotoxin infusion for 6 hrs, whereas groups III (n = 4) and IV (n = 4) received saline. Groups I and III received 7 mg/kg of tobramycin 20 mins after the initiation of the protocol, whereas groups II and IV received saline. MEASUREMENTS AND MAIN RESULTS:: The renal elimination rate of a bolus dose of cefuroxime was chosen as the primary end point. Renal function was also evaluated by urine output, creatinine clearance, plasma cystatin C, plasma urea, and urine NAG (N-acetyl-beta-D-glucoaminidase). After 3 hrs, there were significantly lower cefuroxime elimination rates in the two endotoxin groups than in the nonendotoxin groups. No difference in cefuroxime elimination rates between groups I and II could be detected at any time point. Similarly, there were changes indicating acute kidney injury in urine output, creatinine clearance, and plasma cystatin C in the endotoxin groups with no differences between groups I and II. Plasma urea and urine NAG did not differ between any of the groups. CONCLUSIONS:: The result of this study does not lend any support to the hypothesis that a single dose of tobramycin enhances the risk of acute renal failure in cases with systemic inflammatory response-induced acute kidney injury. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1469335
- author
- Lipcsey, Miklós ; Carlsson, Markus ; Larsson, Anders ; Algotsson, Lars LU ; Eriksson, Mats ; Lukinius, Agneta and Sjölin, Jan
- organization
- publishing date
- 2009
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Critical Care Medicine
- volume
- 37
- issue
- 10
- pages
- 2782 - 2790
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- wos:000270234700015
- pmid:19707126
- scopus:70349668735
- pmid:19707126
- ISSN
- 1530-0293
- DOI
- 10.1097/CCM.0b013e3181a988f8
- language
- English
- LU publication?
- yes
- id
- 17a67cd2-1ccb-4b77-a967-06920d274840 (old id 1469335)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/19707126?dopt=Abstract
- date added to LUP
- 2016-04-01 13:54:20
- date last changed
- 2022-01-27 21:43:52
@article{17a67cd2-1ccb-4b77-a967-06920d274840,
abstract = {{OBJECTIVE:: To evaluate whether the addition of tobramycin further compromises renal function in inflammatory response-induced acute kidney injury. Effective antibiotic treatment in septic shock is crucial for the outcome. The combination of aminoglycosides with different beta-lactam antibiotics offers a broad antimicrobial coverage, rapid bacterial killing, synergistic effects, and low antibiotic-induced endotoxin release. However, aminoglycosides have nephrotoxic effects that may aggravate sepsis-induced acute kidney injury. DESIGN:: Prospective, randomized, placebo-controlled experimental study. SETTING:: University research unit. SUBJECTS:: Twenty-four healthy pigs. INTERVENTIONS:: The animals were anesthetized and randomized to four groups. Groups I (n = 8) and II (n = 8) received endotoxin infusion for 6 hrs, whereas groups III (n = 4) and IV (n = 4) received saline. Groups I and III received 7 mg/kg of tobramycin 20 mins after the initiation of the protocol, whereas groups II and IV received saline. MEASUREMENTS AND MAIN RESULTS:: The renal elimination rate of a bolus dose of cefuroxime was chosen as the primary end point. Renal function was also evaluated by urine output, creatinine clearance, plasma cystatin C, plasma urea, and urine NAG (N-acetyl-beta-D-glucoaminidase). After 3 hrs, there were significantly lower cefuroxime elimination rates in the two endotoxin groups than in the nonendotoxin groups. No difference in cefuroxime elimination rates between groups I and II could be detected at any time point. Similarly, there were changes indicating acute kidney injury in urine output, creatinine clearance, and plasma cystatin C in the endotoxin groups with no differences between groups I and II. Plasma urea and urine NAG did not differ between any of the groups. CONCLUSIONS:: The result of this study does not lend any support to the hypothesis that a single dose of tobramycin enhances the risk of acute renal failure in cases with systemic inflammatory response-induced acute kidney injury.}},
author = {{Lipcsey, Miklós and Carlsson, Markus and Larsson, Anders and Algotsson, Lars and Eriksson, Mats and Lukinius, Agneta and Sjölin, Jan}},
issn = {{1530-0293}},
language = {{eng}},
number = {{10}},
pages = {{2782--2790}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Critical Care Medicine}},
title = {{Effect of a single dose of tobramycin on systemic inflammatory response-induced acute kidney injury in a 6-hour porcine model*}},
url = {{http://dx.doi.org/10.1097/CCM.0b013e3181a988f8}},
doi = {{10.1097/CCM.0b013e3181a988f8}},
volume = {{37}},
year = {{2009}},
}