Journal Article

Adjunctive efficacy of granulocyte colony-stimulating factor on treatment of <i>Pseudomonas aeruginosa</i> pneumonia in neutropenic and non-neutropenic hosts

Chinedum P. Babalola, Charles H. Nightingale and David P. Nicolau

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 53, issue 6, pages 1098-1100
Published in print June 2004 | ISSN: 0305-7453
Published online June 2004 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkh237
Adjunctive efficacy of granulocyte colony-stimulating factor on treatment of Pseudomonas aeruginosa pneumonia in neutropenic and non-neutropenic hosts

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Objectives: Granulocyte colony-stimulating factor (G-CSF) stimulates proliferation of neutrophils and enhances their phagocytic and microcidal activity. Increasing resistance to existing antibacterials and the dearth of new alternatives have complicated the treatment of Gram-negative infections. The aim of this study was to evaluate the efficacy of G-CSF in the treatment of Pseudomonas aeruginosa pneumonia when administered in combination with ceftazidime in both neutropenic and non-neutropenic hosts.

Methods: A group of mice were rendered neutropenic with cyclophosphamide. Pneumonia was induced by intratracheal instillation of ∼5 × 107 cfu/mL and ∼5 × 109 cfu/mL (LD100) of the organism to neutropenic and non-neutropenic mice, respectively. Two hours after inoculation, the mice received normal saline and 5% dextrose, G-CSF (300 µg/kg per day × 3 days), ceftazidime (2000 mg/kg × 2 doses) or a combination of G-CSF and ceftazidime. Survival was monitored at different time points for 5 days.

Results: Treatment with G-CSF showed a dose-dependent increase in survival from 50 to 300 µg/kg. In neutropenic mice, survival was markedly better in the G-CSF + ceftazidime group compared with controls (P = 0.0001), G-CSF (P = 0.0002) or ceftazidime (P = 0.0172). In non-neutropenic mice, survival in the G-CSF + ceftazidime group (20%) was significantly higher than in the control and G-CSF groups (P = 0.0001) but not significantly higher than ceftazidime alone (9%) (P > 0.05).

Conclusions: G-CSF administered in combination with antibiotic after onset of severe P. aeruginosa pneumonia may improve therapeutic outcome and this suggests a new treatment option in the management of pneumonia especially in neutropenic patients.

Keywords: Keywords: G-CSF, immunomodulators, P. aeruginosa, ceftazidime

Journal Article.  2011 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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