Skip to main content

Volume 16 Supplement 3

Sepsis 2012

  • Poster presentation
  • Open access
  • Published:

Role of the clarithromycin immune modulator activity on abdominal microhemodynamics and mortality in severe sepsis

Background

The management of the uncontrolled systemic inflammatory response in the early phase of severe sepsis is still a challenge. Herein we aimed to minimize the acute inflammation phase of sepsis by clarithromycin associated with intravascular volume restoration with an aggressive fluid therapy.

Methods

Wistar rats were distributed into five groups: S, animals submitted to sepsis (DL80; 3 ml Escherichia coli 109 CFU/ml, i.v., n = 6); SCH, animals induced to sepsis after clarithromycin (14 mg/kg, i.v., given 24 and 0 hours before sepsis) and hyperhydration (Ringer lactate 40 ml/kg, i.v., in 20 minutes after the sepsis induction) (n = 6); SC, animals induced to sepsis and treated with clarithromycin (n = 6); SH, animals induced to sepsis and treated with hyperhydration (n = 6); and Sham, animals induced to sham sepsis (n = 4). All invasive procedures were undergone after general anesthesia. The liver, kidney and ileum microcirculation were monitored by Laser Doppler and sidestream darkfield imaging at 2-hour and 26-hour periods. The mortality index was observed for 30 days.

Results

All animals of the SCH and Sham groups survived while the S, SC and SH groups showed 20% survival. Hyperhydration or clarithromycin in sepsis showed a partial and transient improvement of the microcirculation of the abdominal organs, although the association of hyperhydration with clarithromycin (SCH group) showed better effects. In addition, the beneficial microhemodynamic effect under combined therapy was better evidenced in the liver and intestine as compared with the kidney.

Conclusion

The association of clarithromycin and hyperhydration showed a beneficial effect in severe sepsis, possibly by modulating inflammatory response and microcirculation damage, respectively, resulting in subsequent survival; nevertheless, their individual effects were not efficient to inhibit severe sepsis mortality and microcirculation dysfunction.

Acknowledgements

Supported by FAPESP.

Author information

Authors and Affiliations

Authors

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article

Jesus, F., Snak-Souza, C., Dulcini, F. et al. Role of the clarithromycin immune modulator activity on abdominal microhemodynamics and mortality in severe sepsis. Crit Care 16 (Suppl 3), P94 (2012). https://doi.org/10.1186/cc11781

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/cc11781

Keywords