Bowel colonization with resistant gram-negative bacilli after antimicrobial therapy of intra-abdominal infections: observations from two randomized comparative clinical trials of ertapenem therapy

摘要: The selection of resistant gram-negative bacilli by broad-spectrum antibiotic use is a major issue in infection control. aim this comparative study was to assess the impact different antimicrobial regimens commonly used treat intra-abdominal infections on susceptibility patterns bowel flora after completion therapy. In two international randomized open-label trials with laboratory blinding, adults complicated requiring surgery received piperacillin-tazobactam (OASIS 1) or ceftriaxone/metronidazole II) versus ertapenem for 4–14 days. Rectal swabs were obtained at baseline, end therapy, and 2 weeks post-therapy. Escherichia coli Klebsiella spp. tested production extended-spectrum β-lactamase (ESBL). Enterobacteriaceae agent recovered from 19 156 (12.2%) recipients therapy compared 1 (0.6%) patient baseline (p<0.001) OASIS I, 33 193 (17.1%) 5 (2.6%) patients II. Ertapenem-resistant 155 196 0 I II, respectively. Resistant emerged significantly less often during treatment than comparator both II (p<0.001). prevalence ESBL-producers increased among (from 4 [2.1%] 18 [9.3%]) (p<0.001), whereas no recipient colonized an ESBL-producer either study. Selection imipenem-resistant Pseudomonas aeruginosa uncommon all groups. these studies, frequency colonization substantially treated ceftriaxone/metronidazole, but not ertapenem.