Linked Life Data

15990986

Source:http://linkedlifedata.com/resource/pubmed/id/15990986

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
7
pubmed:dateCreated
2005-7-28
pubmed:abstractText
The selection of resistant gram-negative bacilli by broad-spectrum antibiotic use is a major issue in infection control. The aim of this comparative study was to assess the impact of different antimicrobial regimens commonly used to treat intra-abdominal infections on the susceptibility patterns of gram-negative bowel flora after completion of therapy. In two international randomized open-label trials with laboratory blinding, adults with complicated intra-abdominal infection requiring surgery received piperacillin-tazobactam (OASIS 1) or ceftriaxone/metronidazole (OASIS II) versus ertapenem for 4-14 days. Rectal swabs were obtained at baseline, end of therapy, and 2 weeks post-therapy. Escherichia coli and Klebsiella spp. were tested for production of extended-spectrum beta-lactamase (ESBL). Enterobacteriaceae resistant to the agent used were recovered from 19 of 156 (12.2%) piperacillin-tazobactam recipients at the end of therapy compared to 1 (0.6%) patient at baseline (p<0.001) in OASIS I, and from 33 of 193 (17.1%) ceftriaxone/metronidazole recipients at the end of therapy compared to 5 (2.6%) patients at baseline (p<0.001) in OASIS II. Ertapenem-resistant Enterobacteriaceae were recovered from 1 of 155 and 1 of 196 ertapenem recipients at the end of therapy versus 0 and 1 ertapenem recipients at baseline in OASIS I and II, respectively. Resistant Enterobacteriaceae emerged significantly less often during treatment with ertapenem than with the comparator in both OASIS I (p<0.001) and OASIS II (p<0.001). The prevalence of ESBL-producers increased significantly during therapy in OASIS II among 193 ceftriaxone/metronidazole recipients (from 4 [2.1%] to 18 [9.3%]) (p<0.001), whereas no ertapenem recipient was colonized with an ESBL-producer at the end of therapy in either study. Selection for imipenem-resistant Pseudomonas aeruginosa was uncommon in all treatment groups. In these studies, the frequency of bowel colonization with resistant Enterobacteriaceae substantially increased in patients treated with either piperacillin-tazobactam or ceftriaxone/metronidazole, but not in patients treated with ertapenem.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jul
pubmed:issn
0934-9723
pubmed:author
pubmed:issnType
Print
pubmed:volume
24
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
443-9
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:15990986-Adolescent, pubmed-meshheading:15990986-Adult, pubmed-meshheading:15990986-Aged, pubmed-meshheading:15990986-Aged, 80 and over, pubmed-meshheading:15990986-Anti-Bacterial Agents, pubmed-meshheading:15990986-Carrier State, pubmed-meshheading:15990986-Ceftriaxone, pubmed-meshheading:15990986-Digestive System Surgical Procedures, pubmed-meshheading:15990986-Drug Resistance, Bacterial, pubmed-meshheading:15990986-Drug Therapy, Combination, pubmed-meshheading:15990986-Female, pubmed-meshheading:15990986-Gram-Negative Bacteria, pubmed-meshheading:15990986-Gram-Negative Bacterial Infections, pubmed-meshheading:15990986-Humans, pubmed-meshheading:15990986-Intestines, pubmed-meshheading:15990986-Lactams, pubmed-meshheading:15990986-Male, pubmed-meshheading:15990986-Metronidazole, pubmed-meshheading:15990986-Middle Aged, pubmed-meshheading:15990986-Penicillanic Acid, pubmed-meshheading:15990986-Piperacillin, pubmed-meshheading:15990986-beta-Lactams
pubmed:year
2005
pubmed:articleTitle
Bowel colonization with resistant gram-negative bacilli after antimicrobial therapy of intra-abdominal infections: observations from two randomized comparative clinical trials of ertapenem therapy.
pubmed:affiliation
Merck & Co., Whitehouse Station, NJ, USA. mark_dinubile@merck.com
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Randomized Controlled Trial, Multicenter Study