Effects of glucocorticoids in ventilated piglets with severe pneumonia

¹ Servei de Pneumologia. Institut Clínic del Tòrax. Hospital Clínic de Barcelona. IDIBAPS. Universitat de Barcelona, España
² División Neumonología
³ Centro Universitario de Cirugía Experimental
⁴ Departamento de Bioquímica Clínica
⁵ División Patología, Hospital de Clínicas, Universidad de Buenos Aires, Argentina

^* To whom correspondence should be addressed. E-mail: atorres{at}ub.edu.

	Abstract

There is clinical evidence suggesting that glucocorticoids may be useful in severe pneumonia, but the pathogenic mechanisms explaining these beneficial effects are unknown.

The aim of the study was to determine the effects of adding glucocorticoids to antibiotic treatment in an experimental model of severe pneumonia.

Fifteen Lagerwhite-Landrace piglets were ventilated for 96h. After intubation, a solution containing 75 ml of Pseudomona aeruginosa (10⁶ cfu·ml^-1) was bronchoscopically inoculated. Twelve hours after inoculation, the animals were randomized into 3 group; 1) untreated, 2) treated with ciprofloxacin and 3) treated with ciprofloxacin plus methylprednisolone. Physiologic and laboratory parameters were monitored throughout the study. Proinflammatory cytokines were measured in serum and in bronchoalveolar lavage (BAL). Histopathology of the lungs and cultures from blood, BAL and lungs were performed.

At the end of the study, piglets receiving the antibiotic plus glucocorticoids showed: 1) a decrease in the concentration of IL-6 in BAL and 2) a decrease in the global bacterial burden both in BAL and lung tissue.

In conclusion, in this experimental model of pneumonia, the association of glucocorticoids with antibiotics attenuates local inflammatory response and decreases bacterial burden in the lung.

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