Comparative Effects of Single-Dose Ceftriaxone Versus Three Oral Antibiotic Regimens on Stool Colonization by Resistant Bacilli in Children

Toltzis, Philip; Dul, Michael; O’Riordan, Mary Ann; Toltzis, Hasida; Blumer, Jeffrey L.

doi:10.1097/01.inf.0000247130.11902.64

Cited by 6 publications

(3 citation statements)

References 51 publications

(42 reference statements)

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“…Previously, antibiotic‐related dysbiosis was believed to be transient (Welling et al, ; Cavallaro et al, ; Toltzis et al, ), but recent studies using molecular methods, most in mice or adults, have revealed that antibiotic‐associated changes in microbiota composition can be persistent. For example, microbiota differences persisted for up to 2 years in clindamycin‐exposed adults, compared with unexposed patients (Jernberg et al, ; Jernberg et al, ).…”

Section: Influences On Microbiotamentioning

confidence: 99%

Development of the infant intestinal microbiome: A bird's eye view of a complex process

Meropol

Edwards

2015

Birth Defects Research Pt C

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Infants undergo profound shifts in colonizing intestinal microorganisms during their first year, especially during and after birth and during weaning. Microbiota are passed to infants through the placenta, during the vaginal birth process, and from early diet and other environmental exposures. These microbiota play an active role in the development of healthy infant metabolic and immunologic systems; profound shifts in microbiotal populations can be persistent, are associated with immediate alterations in gene expression, metabolic, immunologic, and neurologic function, and with downstream metabolic and immunologic consequences such as obesity, allergies, asthma, autoimmune diseases, and potentially neurologic conditions. Many modern exposures, including Cesarean section, formula feeding, and antibiotics, have been associated with microbiome shifts, and also with downstream diseases; while many published studies considered exposures individually, a more comprehensive understanding of their interaction and impact will consider the entirety of the infant’s environment. It is not possible, nor desirable, to return to a world without toilets, sewers, tap water, delivery room antisepsis, Cesarean sections, antibiotics, immunizations, and refrigerators; our other alternative is to better understand these complex changes in infant developmental and molecular physiology. Protecting and repairing the developmental processes of the healthy infant microbiome is the modern medical frontier.

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Section: Influences On Microbiotamentioning

confidence: 99%

Development of the infant intestinal microbiome: A bird's eye view of a complex process

Meropol

Edwards

2015

Birth Defects Research Pt C

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“…combination of organism and antibiotic). Studies involving S. pneumoniae resistant to either beta-lactams or macrolides, met this requirement and 13 studies [35,36,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] (n=11049 participants) were included in the analysis (Figure 1).…”

Section: Yield Of Search Strategymentioning

confidence: 99%

β-Lactam–Resistant Streptococcus pneumoniae Dynamics Following Treatment: A Dose-Response Meta-analysis

Griskaitis

Furuya‐Kanamori

Allel

et al. 2022

Clinical Infectious Diseases

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Background Patient exposure to antibiotics promotes the emergence of drug-resistant pathogens. The aim of this study was to identify whether the temporal dynamics of resistance emergence at the individual-patient level were predictable for specific pathogen-drug classes. Methods Following a systematic review, a novel robust error meta-regression (REMR) method for dose-response meta-analysis (DRMA) was used to estimate the odds ratio (OR) for carrying resistant bacteria during and following treatment compared to baseline. Probability density functions fitted to the resulting dose-response curves were then used to optimize the period during and/or after treatment when resistant pathogens were most likely to be identified. Results Studies of Streptococcus pneumoniae treatment with β-lactam antibiotics demonstrated a peak in resistance prevalence among patients four days after completing treatment with a 3.32-fold increase in odds (95%CI 1.71 - 6.46). Resistance waned more gradually than it emerged, returning to pre-exposure levels one month after treatment (OR 0.98, 95%CI 0.55 - 1.75). Patient isolation during the peak dose-response period would be expected to reduce the risk that a transmitted pathogen is resistant equivalently to a 50% longer isolation window timed from the first day of treatment. Conclusions Predictable temporal dynamics of resistance levels have implications both for surveillance and control.

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“…Since the bacteria causing UTI usually start life as bowel flora, this mechanism can directly increase likelihood of a child's UTI organism being resistant. 8 An individual predominantly colonised by a resistant organism is more likely to transmit a resistant rather than susceptible bacterium to an infectious contact (indirect effect). Finally an antibiotic treated individual, in whom their susceptible commensal flora has been eradicated, is more likely to acquire a new (resistant) bacterium (direct and indirect effects).…”

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confidence: 99%

Antibiotics for childhood urinary tract infection: can we be smarter?

Costelloe¹

2013

Br J Gen Pract

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Comparative Effects of Single-Dose Ceftriaxone Versus Three Oral Antibiotic Regimens on Stool Colonization by Resistant Bacilli in Children

Abstract: A single intramuscular dose of ceftriaxone had a similar effect on the prevalence of antibiotic-resistant Gram-negative facultative bacilli in the stool of healthy children when compared with commonly used oral agents.

Cited by 6 publications

References 51 publications

Development of the infant intestinal microbiome: A bird's eye view of a complex process

Development of the infant intestinal microbiome: A bird's eye view of a complex process

β-Lactam–Resistant Streptococcus pneumoniae Dynamics Following Treatment: A Dose-Response Meta-analysis

Antibiotics for childhood urinary tract infection: can we be smarter?

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