EFFECTS OF ANTIBIOTICS ON CHANGES IN CYTOKINES AND ACUTE-PHASE PROTEINS AFTER LIVER RESECTION

Abstract

Cytokines and acute phase-proteins are important in infectious diseases and under surgical stress, especially in postoperative infections. To study the effects of antibiotics on changes in cytokines and acute-phase proteins after surgery, we measured serum levels of interleukin 6 (IL-6), elastase from granulocytes, pancreatic secretory trypsin inhibitor (PSTI), C-reactive protein (CRP), and fibrinogen after liver resection in 12 patients with hepatocellular carcinoma. In the six of the 12 patients (group A), flomoxef (FMOX, 4 g/day) was administered intravenously for 3 days after surgery. In six other patients (group B), imipenem-cilastatin (IPM/CS, 1g/day) was administered for the same period. Group A was comparable to group B in age distribution of patients, preoperative hepatic function, operating time, and intraoperative bleeding volume. No patients had postoperative complications. The mean changes in serum levels of IL-6 in group B were smaller than those in group A. The changes in serum levels of elastase, PSTI, CRP, and fibrinogen were also smaller than those in group A. These results suggest that IPM/CS suppressed the usual increases after major surgery in the levels of IL-6 and acute-phase proteins. This preparation may suppress the progress of hypercytokinemia in the systemic inflammatory response. The effects of antibiotics on cytokines and acute-phase proteins should be considered in the choice of antibiotics for severe infectious diseases.