Oral antibiotic prophylaxis can influence the inflammatory response in aortic aneurysm repair: results of a randomized clinical study
| Autor: | R.G. Holzheimer |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Calcitonin Male Ofloxacin Calcitonin Gene-Related Peptide Administration Oral Neopterin Procalcitonin Cefotiam Aortic aneurysm chemistry.chemical_compound Postoperative Complications Anti-Infective Agents Oral administration medicine Humans Pharmacology (medical) Prospective Studies Antibiotic prophylaxis Protein Precursors Prospective cohort study Pharmacology Inflammation business.industry Interleukin-6 Antibiotic Prophylaxis medicine.disease Aortic Aneurysm Endotoxins Infectious Diseases Oncology chemistry Anesthesia Cytokines Female business medicine.drug |
| Zdroj: | Journal of chemotherapy (Florence, Italy). 15(2) |
| ISSN: | 1120-009X |
| Popis: | The purpose of this prospective, randomized study was to evaluate the effect of oral ofloxacin prophylaxis on endotoxin/cytokine release in aortic aneurysm repair, in 25 patients with infrarenal aortic aneurysm at a University hospital. Outcome parameters included complications after operation; endotoxin and endotoxin neutralizing capacity, IL-6, procalciton and neopterin. All patients had the standard perioperative antibiotic prophylaxis (2 g cefotiam). 12 patients randomly received oral ofloxacin prophylaxis (group 1) the day before the operation (200 mg/2x12h); 13 patients were controls (group 2). Data were analyzed by chi-square analysis, Mann-Whitney and Wilcoxon analysis. Ofloxacin had no effect on the occurrence of complications or on the peripheral endotoxin levels. Ofloxacin-treated patients showed increased endotoxin neutralizing capacity (ENC) 30 min after clamping compared to controls (15.8+/-15 vs 262.8+/-709 p=0.005) and increased IL-6 levels preoperatively and 30 min after clamping. Patients with complications had significantly higher IL-6 levels early during the operation and postoperatively (30 min after clamping: 36.4+/-15.1 vs 18.8+/-11.9 pg/ml p=0.01; 2nd postoperative day: 768+/-688 vs 225+/-322 pg/ml p=0.005). Ofloxacin prophylaxis had no effect on procalcitonin, or neopterin plasma levels. Neither procalcitonin nor neopterin could detect patients with complications IL-6 plasma levels predicted the occurrence of complications in aortic aneurysm repair. Oral ofloxacin prophylaxis may influence the ENC and IL-6 plasma levels but had no effect on complications, endotoxin and other inflammatory mediators. |
| Databáze: | OpenAIRE |
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