Pulmonary Drug Discovery & Therapy (Track)
Clindamycin is superior to clindamycin-dexamethasone combination in treatment of Porphyromonas gingivalis aspiration pneumonia in an experimental murine model
Petelin M
Dept. of Oral Medicine and Periodontology
Faculty of Medicine, University of Ljubljana
Abstract:
Introduction: P. gingivalis is associated with aspiration pneumonia. Excessive local inflammatory response can result in a poor outcome, but adjunctive corticosteroid use in pneumonia is controversial.
Materials and methods: Mice were intratracheally inoculated with 2.9x10(9) CFU P. gingivalis. Two hours after inoculation, mice were treated with clindamycin (C) (40mg/kg aerosolized, 5min), dexamethasone (D) (2mg/kg aerosolized, 5min), C+D combination, or were not treated (PG) (24 mice per group). Animals were euthanized at 6, 24, 72 and 168h after inoculation. Levels of TNF-alfa, soluble TNF-alfa receptors (sTNFR1 and 2), IL-1beta and IL-6 in the serum and lung-homogenate supernatant were determined, and lungs histopathologically evaluated. The findings were compared to those found in 24 sham-inoculated mice.
Results: Clindamycin treatment resulted in the fastest (72h) resolution of mild pneumonia with an early (6-24h) normalization of local and systemic TNF-alfa, IL-1beta and IL-6 levels. Similar was observed in mice treated with C+D, but later. Severe pneumonia with delayed resolution was observed in D-group mice (compared to PG group). Favorable course of pneumonia was associated with an early (24h) local elevation of sTNFRs.
Conclusion: Short local administration of clindamycin or clindamycin-dexamethasone combination significantly improves the course of P. gingivalis-aspiration pneumonia, more if clindamycin alone is used.
