Inappropriate Inflammatory Response to Antibiotic Treatment in Relation to the Presence of Resistant Bacteria

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Objectives The postantibiotic inflammation is an ill‐defined phenomenon. We sought to appreciate it by the kinetic properties of inflammatory biomarkers, such as C‐reactive protein (CRP) and its response to antibiotic treatment. Methods A cohort of patients admitted to the department of internal medicine over a 7‐year period and who were diagnosed with sepsis had their CRP kinetics, expressed as CRP velocity (CRPv) and estimated CRPv (eCRPv), analyzed and compared prior to and postantibiotic treatment administration. Results Forty‐five septic patients were studied. Kinetic properties of inflammatory markers before and after antibiotic therapy were 1.4 [0.5–2.7] mg/L/h and 5.8 [3.6–7.7] mg/l/h, respectively ( p < 0.001) in the group of patients infected by nonresistant bacteria, whereas no such significant difference was noted in the resistant bacteria group. Conclusion Postantibiotic inflammation is influenced by interactions between the innate immune system and the effect of antibiotic treatments and not necessarily a natural course of the inflammatory response to the invading organism.