Beta-lactam antibiotics have immunomodulatory effects in vitro, including changes consistent with sepsis-induced immunosuppression
Authors' conclusion
Beta-lactam antibiotics have immunomodulatory effects in vitro, including changes consistent with sepsis-induced immunosuppression at clinically relevant doses.
Study context
- Population
- Peripheral blood mononuclear cells from ED patients with bacterial infection
- Comparison
- Narrow-spectrum (amoxicillin, cefuroxime) vs broad-spectrum (piperacillin-tazobactam, meropenem) beta-lactams at low and high concentrations, with and without stimulation (LPS or anti-CD3/CD28 beads)
- Outcome
- Monocyte and lymphocyte immunophenotype
Methodological detailsin vitro, spectral flow cytometry
- In vitro
- Spectral flow cytometry
Main finding
As reported in the abstract
- Higher-dose beta-lactams associated with increased monocyte CCR2 and decreased CD14 expression
- Cefuroxime, meropenem and piperacillin additionally reduced monocyte HLA-DR, NOX-2, CLIP and NF-κB expression with increased CD80
- Beta-lactam exposure associated with increased CD4+ lymphocyte viability
- Amoxicillin additionally reduced PD-1 expression and proliferation and increased IL-7R expression
- Minimal changes in CD8+ lymphocytes, at lower antibiotic doses, or in unstimulated cells
Original publication
Beta-lactam antibiotics have immunomodulatory effects in vitro, including changes consistent with sepsis-induced immunosuppression. Crit Care. Published 17 August 2026. doi:10.
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