Immunologic effect and clinical impact of erythromycin in septic patients: A randomized clinical trial.

Autor: Trifi A; Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia. Electronic address: trifiahlem2@gmail.com., Tlili B; Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia., Kallel Sellami M; Immunology Laboratory, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia., Feki M; Biochemistry Laboratory, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia., Mehdi A; Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia., Seghir E; Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia., Messaoud L; Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia., Abdellatif S; Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia., Ben Lakhal S; Medical Intensive Care Unit, La Rabta Teaching Hospital, Rue Jabbari, 1007 Tunis, Tunisia.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2024 Jun; Vol. 81, pp. 154533. Date of Electronic Publication: 2024 Feb 14.
DOI: 10.1016/j.jcrc.2024.154533
Abstrakt: To investigate the potential regulatory effect of erythromycin added to standard care in septic patients on sepsis biomarkers and clinical outcome. It was a single-blind randomized trial including critical septic patients. The primary endpoint was the change in the TNF/IL-10 ratio between days 0 and 6. Changes in other biomarkers, vasopressor use, and 28-day mortality were secondary endpoints. One hundred and ten patients were examined (erythromycin group, n = 55 versus placebo group, n = 55). Clinical features of the groups were well matched. Erythromycin addition had no beneficial effects on the TNF/IL-10 ratio or mortality (51% vs. 47%, p = 0.62). Both groups' serum TNF/IL-10 ratios did not significantly rise (from 0.48 [0.34-1.18] to 0.59 [0.21-1.10] vs. 0.65 [0.25-1.14] to 0.93 [0.24-1.88] in the erythromycin and placebo groups, respectively; p values = 0.86 and 0.12). Serum Procalcitonin (PCT) and CRP dropped considerably in the Erythromycin group, whereas only PCT showed a drop in the placebo group. On day 6, the non-survivors' serum TNF/IL-10 ratio was lower than that of the survivors (0.55 [0.17-1.04] vs 1.08 [0.4-2.28], p = 0.029). Neither the pro/anti-inflammatory imbalance nor the mortality were impacted by the addition of erythromycin to standard care in septic patients (ClinicalTrials.gov ID: NCT04665089 (11/12/2020)).
Competing Interests: Declaration of competing interest The author(s) declare no conflict of interests.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
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