TY - JOUR
T1 - Antibiotic resistance among anaerobes
T2 - What does it mean?
AU - Hecht, David W.
AU - Vedantam, Gayatri
AU - Osmolski, James R.
PY - 1999/6
Y1 - 1999/6
N2 - Antibiotic resistance among anaerobes is increasing, with significant resistance to clindamycin, cephalosporins, cephamycins, and penicillins noted at community hospitals and major medical centers. A total of 615 anaerobes isolated from various Chicago area hospitals in 1996 were tested against 13 antibiotics, and the resistance patterns compared with similar data from 1991. For the Bacteroides fragilis group anaerobes, the most effective antibiotics were the B-lactam/B-lactamase inhibitor combination agents, carbapenems, trovafloxacin and metronidazole. High levels of resistance to clindamycin, piperacillin, cefoxitin and ceftizoxime were seen 1996. For non-B. fragilis group anaerobes, resistance was mush lower, and was notable only in Clostridium spp. (clindamycin and cephamycins) and Prevotella spp. (clindamycin and piperacillin). Despite the prevalence of antibiotic resistance among anaerobes, the frequency of antimicrobial susceptibility testing of anaerobes is declining. There are a number of factors that account for this decline, including a general reduction in funding of hospital clinical laboratories, a concomitant loss of expertise at these institutions, a lack of automated testing for anaerobes, and a failure to consider resistance as important to clinicians. The case for increased susceptibility testing is built upon the changing patterns of resistance such as those reported in this paper, the identification and transfer of genetic determinants corresponding to antibiotic resistance, as well as the correlation of resistance and clinical outcome. (C) 1999 Academic Press.
AB - Antibiotic resistance among anaerobes is increasing, with significant resistance to clindamycin, cephalosporins, cephamycins, and penicillins noted at community hospitals and major medical centers. A total of 615 anaerobes isolated from various Chicago area hospitals in 1996 were tested against 13 antibiotics, and the resistance patterns compared with similar data from 1991. For the Bacteroides fragilis group anaerobes, the most effective antibiotics were the B-lactam/B-lactamase inhibitor combination agents, carbapenems, trovafloxacin and metronidazole. High levels of resistance to clindamycin, piperacillin, cefoxitin and ceftizoxime were seen 1996. For non-B. fragilis group anaerobes, resistance was mush lower, and was notable only in Clostridium spp. (clindamycin and cephamycins) and Prevotella spp. (clindamycin and piperacillin). Despite the prevalence of antibiotic resistance among anaerobes, the frequency of antimicrobial susceptibility testing of anaerobes is declining. There are a number of factors that account for this decline, including a general reduction in funding of hospital clinical laboratories, a concomitant loss of expertise at these institutions, a lack of automated testing for anaerobes, and a failure to consider resistance as important to clinicians. The case for increased susceptibility testing is built upon the changing patterns of resistance such as those reported in this paper, the identification and transfer of genetic determinants corresponding to antibiotic resistance, as well as the correlation of resistance and clinical outcome. (C) 1999 Academic Press.
KW - Antibiotic resistance
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U2 - 10.1006/anae.1999.0227
DO - 10.1006/anae.1999.0227
M3 - Article
AN - SCOPUS:0033141269
VL - 5
SP - 421
EP - 429
JO - Anaerobe
JF - Anaerobe
SN - 1075-9964
IS - 3-4
ER -