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Byung C. Moon, MD; Murray J. Girotti, MD; Simon F. G. Wren, MD; Richard Dawson; Depinder Brar

Arch Surg. 1986;121(1):73-76.

Abstract
• The effects of antibiotics and other commonly used medications on the human polymorphonuclear neutrophil leukocytes' (PMNs) nicotinamide-adenine dinucleotide phosphatereduced (NADPH) oxidase activity have been investigated in vitro. Five antibiotics (penicillin G sodium, cefamandole nafate, metronidazole hydrochloride, clindamycin phosphate, and tobramycin sulfate, and a triple combination of penicillin G sodium-metronidazole hydrochloride-tobramycin sulfate) and two sedatives (morphine sulfate and diazepam) were incubated with normal human PMNs at therapeutic, infratherapeutic, and supratherapeutic drug levels. The superoxide dismutase-inhibitable, NADPH-dependent reduction of cytochrome C in the PMNs was studied after stimulation with formyl-methionyl-leucine-phenylalanine. Tobramycin sulfate and the triple combination of penicillin G sodium—metronidazole hydrochloride-tobramycin sulfate significantly reduced the NADPH oxidase activity at all dosages studied. Clindamycin phosphate, morphine sulfate, and diazepam also showed significant reduction at therapeutic and supratherapeutic concentrations. Penicillin G sodium, cefamandole nafate, and metronidazole hydrochloride did not cause a decrease in enzyme activity at any levels tested. We conclude that NADPH oxidase activity can be adversely affected by the circulating levels of common antibiotics and sedatives.

(Arch Surg 1986;121:73-76)

Author Affiliations
From the Department of Surgery, Queen's University, Kingston, Ontario. Dr Girotti is now with the Department of Surgery, Toronto General Hospital.

Footnotes
Accepted for publication Oct 10, 1985.

Read before the Fifth Annual Meeting of the Surgical Infection Society, New Orleans, April 29, 1985.

Reprint requests to Department of Surgery, Toronto General Hospital, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4 (Dr Girotti).

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