Despite the use of broad-spectrum antibiotics, aggressive fluid resuscitation, vasopressor support, the mortality associated with Gram-negative sepsis and septic shock has not decreased significantly in the last two decades. The consequences of host exposure to endotoxin and the relationship of antibiotic administration to endotoxin release have become important areas of intense interest. In vitro studies have demonstrated that there was a difference in endotoxin release between PBP-3 specific antibiotics (β-lactam antibiotics) and PBP-2 specific antibiotics (carbapenems). This is the first clinical report of surgical patients admitted to the surgical and anaesthesiology intensive care unit on the missing endotoxin release after imipenem treatment; however cefotaxime and ceftriaxone showed significantly more positive endotoxin tests in the plasma when compared to imipenem. Ciprofloxacin and vancomycin were intermediate in endotoxin release and tobramycin did not cause endotoxin release. There were also significant differences in endotoxin neutralizing capacity. IL-6 levels were decreased after imipenem faster than after ceftriaxone or cefotaxime; ciprofloxacin seemed to increase IL-6. Endotoxin may be harmful in patients where the immune system has been continuously challenged. Timing, dosage, or combination with other compounds as well as the effect of antibiotics on macrophages need to be tested in larger clinical trials. In this respect a consecutive study was started.

Background Discovery of antibiotics opened a new era in the treatment of bacterial diseases. However, the microorganisms are able to adapt and resist the effects of the drugs. Objective Our study is aimed to investigate the sensitivity of clinical specimens to antibiotics. Methods Clinical samples of 280 case record forms were collected at departments of surgery, urology and otorhinolaryngology in an ambulatory clinic (Tver, Russia) during 2019. The results of microbiologically assessed isolates from pharynx, nose, ears, eyes, wounds, sputum and urine underwent statistical analysis. Results The outcomes confirmed a general trend of reduced susceptibility of bacteria to antibiotics. The worst result was shown by protected Amoxicillin; practically no microorganisms were sensitive to it. Protected Cephalosporins Cephalosporins of IV generation and Imipenem were among the best, although not highly sensitive to all the pathogens. Conclusion United efforts of all states are required to combat the growing antibiotic resistance. It is necessary to adhere to strict regulations on dispense of antibiotics in pharmacies and the use of antibiotics therapy

The purulent-septic infection caused by Staphylococcus aureus is one of the biggest problems of modern medicine. There are some strategies to control the increasing antibiotic resistance of bacteria. They are the development and introduction of new antibacterial drugs into surgical practice, the improvement of antimicrobial therapy methods and the rotation of antibacterial drugs [1, 2, 3]. Staphylococcus aureus is one of the most common causative agents of infections of various localizations. The development of mechanisms of antibiotic resistance of bacteria is more often determined by genes located on the bacterial chromosome or Rplasmids. Particular attention is paid to methicillinresistant staphylococci (MRS strains). They are registered in nosocomial or out-of-hospital infections. The resistance of staphylococci to β-lactam antibiotics is due to the presence of the mec A gene. It encodes the penicillin-binding protein (PBP). The mec A gene is located on a mobile genetic element. This element is called the staphylococcal chromosome cassette (SCCmec). Methicillin-resistant Staphylococcus aureus is resistant to all β-lactam antibiotics. Currently, it is necessary to use combinations of antibacterial drugs for the treatment of infections caused by methicillinresistant staphylococci.