Effects of empirical antibiotic administration on the level of C-Reactive protein and inflammatory markers in severe burn patients.

Severe burns lead to a high level of inflammation and high risk of infection. Inflammatory biomarkers are usually used to predict the severity of inflammation or infection and to assess the efficacy of antibiotics. The use of antibiotics in burns is still controversial. The aim of this study is to assess the effects of empirical antibiotics on level of C-reactive protein (CRP) and other inflammatory markers (leucocytes, neutrophils, lymphocytes, and ratio of neutrophils-lymphocytes) in severe burn patients. This cohort study was conducted in the burn unit of Dr. Soetomo Hospital between April and November 2019. CRP and other inflammatory markers were measured on admission, day 5, and day 7 after the administration of empirical antibiotics. Fifteen severe burn patients were enrolled in this study. All patients received Ceftazidime, 3x1 gram during seven days of hospitalization. CRP level reduced from 15,78±7,5 mg/dl to 14,98±10,29 mg/dl (p=0,705) by paired-t-test. There were no significant differences in mean decline of CRP between day 0-5 and 0-7. There was no decrease in inflammatory markers, including leucocytes, neutrophils, lymphocytes and ratio of neutrophils-lymphocytes during seven days of empirical antibiotic administration. Our conclusions are that the administration of ceftazidime as an empirical antibiotic lowers CRP level, although not significantly, while there is no decrease in several inflammatory markers.

Les brûlures étendues sont responsables d'une inflammation systémique et d'un risque élevé d'infection. Les biomarqueurs sont fréquemment utilisés pour évaluer la sévérité de l'inflammation ou de l'infection et surveiller l'efficacité de l'antibiothérapie. Le but de cette étude était d'évaluer les effets d'une antibiothérapie probabiliste sur les niveaux de CRP et d'autres marqueurs de l'inflammation (leucocytes, neutrophiles, lymphocytes, rapport neutrophiles/lymphocytes) chez des patients gravement brûlés. Il s'agissait d'une étude de cohorte conduite chez 15 patients hospitalisés dans le CTB de l'hôpital Dr Soetomo entre avril et novembre 2019. Ils recevaient 1 g x 3 de ceftazidime IV pendant 7 jours, les marqueurs de l'inflammation étant mesurés à l'entrée, à J5 et à J7 de l'antibiothérapie. La CRP passait de 157,8 +/- 75 à 149,8 +/- 10,29 mg/L (NS, test t apparié). Il n'y avait aucune baisse significative de quelque marqueur que ce soit sous ceftazidime. Nous en concluons que l'administration systématique de ceftazidime n'a pas d'effet significatif sur les marqueurs de l'inflammation.

Optimization of the culture medium for growth and the kinetics of lactate fermentation by Pediococcus sp. ISK-1.

The growth of a newly isolated strain of Pediococcus sp., designated ISK-1, was very slow and the concentration of cells in the medium remained low. Fermentation with an initial 30 g/liter glucose required about 60 h. To stimulate fermentation, we attempted to optimize the medium by flask culture and jar fermentation tests. Mevalonic acid and mieki (soy bean hydrolyzate) stimulated fermentation and increased the rate of formation of DL-lactate. Kinetic analysis of the fermentation showed that mevalonic acid markedly increased the specific glucose consumption rate and the specific lactate production rate. Mieki and mevalonic acid had a synergistic effect, but the effect of mevalonic acid was different from that of mieki.