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Clinical consequences of development of resistance to third generation cephalosporins

  • Articles
  • Current Topic Inducible Beta-Lactamases: Enzymes of Increasing Clinical Importance
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Abstract

Eighteen patients are described in whom initially sensitive microorganisms were replaced by resistant isolates during administration of ceftriaxone (n=8), cefoperazone (n=5), moxalactam (n=4), cefotaxime (n=2) or ceftazidime (n=1), despite combination with aminoglycosides. All patients had documented gram-negative infections; in 12 patients underlying haemaotological diseases were present. Resistant strains ofEnterobacter cloacae (14),Serratia marcescens (4),Klebsiella oxytoca (3),Pseudomonas aeruginosa (2) andCitrobacter freundii (2) emerged within 2 to 19 (mean 9) days after the beginning of treatment. In 12 patients relapse or secondary infections occurred. Seven of the patients with haematological disorders died. Resistance development was seen in 8 of 29 patients on ceftriaxone and 4 of 10 patients on moxalactam during prospective evaluations; the other drugs were used sporadically. Thus, selection of resistant bacteria is relatively frequent and may have serious clinical consequences in patients with impaired host-defense mechanisms.

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Authors and Affiliations

  1. Department of Medicine, University Hospital (Kantonspital), Basel, Switzerland

    F. Follath, E. Costa, A. Thommen & R. Frei

  2. Department of Microbiology, Biozentrum, University of Basel, Switzerland

    A. Burdeska & J. Meyer

Authors
  1. F. Follath
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  2. E. Costa
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  3. A. Thommen
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  4. R. Frei
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  5. A. Burdeska
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  6. J. Meyer
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Follath, F., Costa, E., Thommen, A. et al. Clinical consequences of development of resistance to third generation cephalosporins. Eur. J, Clin. Microbiol. 6, 446–450 (1987). https://doi.org/10.1007/BF02013108

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