Co-administration of phospholipid emulsion with first dose bacteriocidal antibiotic may retard progression of the sepsis response in gram negative septicaemia.

Abstract

Endotoxic lipopolysaccharide (LPS) is a major constituent of the outer membrane of the gram-negative bacillus, and its' release a potent pro-inflammatory stimulus. Unchecked the cytokine cascades unleashed by blood borne LPS leads to clinical manifestations of severe sepsis and septic shock. Experimentally exogenous administration of cell-wall specific bacteriocidal drugs are known to precipitate endotoxin release and contribute to development of the sepsis syndrome. Mitigation of the inflammatory septic response with intravenous infusion of phospholipid emulsion has been demonstrated in vivo, with phospholipid credited with binding and neutralizing circulating endotoxin. We therefore propose co-administration of phospholipid emulsion preparations in conjunction with potent cell wall specific antibacterial agents in gram-negative sepsis - hypothesizing that released LPS may be immediately sequestered by phospholipid thereby blunting the severity of the developing septic response.

• Authors: Martyn Harvey, Grant Cave
• Journal: Medical hypotheses (Med Hypotheses) Vol. 83 Issue 5 Pg. 563-5 (Nov 2014) ISSN: 1532-2777 [Electronic] United States
• PMID: 25225084 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Emulsions
• Endotoxins
• Lipopolysaccharides
• Lipoproteins, HDL
• Phospholipids

Topics

• Anti-Bacterial Agents (administration & dosage)
• Bacillus (metabolism)
• Cell Wall (drug effects, metabolism)
• Emulsions
• Endotoxins (chemistry)
• Gram-Negative Bacteria (drug effects)
• Hemodynamics
• Humans
• Inflammation
• Lipopolysaccharides (chemistry)
• Lipoproteins, HDL (administration & dosage)
• Phospholipids (administration & dosage, chemistry)
• Sepsis (drug therapy, microbiology)