European Journal of Clinical Microbiology

, Volume 6, Issue 4, pp 446–450 | Cite as

Clinical consequences of development of resistance to third generation cephalosporins

  • F. Follath
  • E. Costa
  • A. Thommen
  • R. Frei
  • A. Burdeska
  • J. Meyer
Articles Current Topic Inducible Beta-Lactamases: Enzymes of Increasing Clinical Importance


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.


Pseudomonas Aeruginosa Cephalosporin Ceftriaxone Cefotaxime Aminoglycosides 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1987

Authors and Affiliations

  • F. Follath
    • 1
  • E. Costa
    • 1
  • A. Thommen
    • 1
  • R. Frei
    • 1
  • A. Burdeska
    • 2
  • J. Meyer
    • 2
  1. 1.Department of MedicineUniversity Hospital (Kantonspital)BaselSwitzerland
  2. 2.Department of Microbiology, BiozentrumUniversity of BaselSwitzerland

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