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KMID : 0350519950480030747
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Journal of Catholic Medical College
1995 Volume.48 No. 3 p.747 ~ p.754
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Effect of Ceftiaxone and Dexamethasone on the Inflammation and TNFαActivity in Experimental Rabbit Pneumococcal Meningitis
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Abstract
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It is generally accepted that tumor necrosis factor alpha (TNFα)plays a important role in the aggravation of inflammation in the bacterial meningitis through the following mechanisms : 1) endothelial damage, 2) induction of adhesion molecule on
the
endothelial cell 3) recruitment of leukocytes in cerebrospinal fluid (CSF).
In a rabbit meningitis model, we attempted to evaluate whether antibiotics-induced bacteriolysis can induce the elevation of the TNFαlevel and leukocyte in CSF, and whether dexamethasone can suppress the elevation of TNFαlevel. We also tried to
assess
the effective administration timing of dexamethasone.
Meningitis was induced by intracisternal inoculation of Streptococcus pneumoniae. We designed four groups : group 1. Untreated conrol (5 rabits) ; group 2. Lone ceftriaxone at 6 hours after inoculation (5 rabbits) ; group 3. Dexamethasone at 30
min.
before ceftriaxone treatment (5 rabbits) ; group 4. Dexamethasone at 30 min. after ceftriaxone treatment (5 rabbits).
The results were as follows : First, the CSF WBC counts in group 3 and 4 were significantly lower than those in group 1 and 2 at 6 hours and 14 hours after ceftiaxone treatment (P<0.05). Second, the CSF TNFα titers in group 2 were significantly
higher
than those in group 1 at 2 hours and 6 hours after ceftriaxone treatment (P<0.05). Third, the CSF TNFα titers in group 3 were significanly lower than those in group 2 at 2 hours and 6 hours after ceftriaxone treatment (P<0.05). Fourth. The CSF
TNFα
titers in group 4 were significantly lower than those in group 2 at 6 hours but higher than those in group 3 at 2 hours after ceftrixone treatment (P<).05).
We conclude that ceftriaxone therapy in experimental rabbit meningitis exacerbates the meninge al inflammation by TNFα production and dexamethasone pretreatment is effective in inhibition of CSF TNFα production. Therefore, we suggest that
dexamethasone might be administered before antibiotics therapy in bacterial meningitis treatment.
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