Emergence of trimethoprim resistance in fecal flora

Huovinen, Pentti; Mattila, T.; Kiminki, O; Pulkkinen, Leena; Huovinen, Saara; Koskela, Markku; Sunila, R; Toivanen, Paavo

doi:10.1128/aac.28.2.354

Cited by 14 publications

(14 citation statements)

References 16 publications

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“…Heavy gastrointestinal colonization of TMP-resistant bacteria during TMP or TMPsulfonamide treatment has been shown to occur during travel for 2 weeks in Mexico (59,60). Although TMP has also been widely used in Finland, gastrointestinal colonization of TMP-resistant strains was not found after 10 days of treatment of urinary tract infections with TMP or a TMPsulfonamide combination (42). This difference might be explained by a more extensive, less restricted consumption of TMP in Mexico (42; S. Levy, Letter, N. Engl.…”

Section: Spread Of Tmp Resistancementioning

confidence: 98%

Trimethoprim resistance

Huovinen

1987

Antimicrob Agents Chemother

Self Cite

101

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Section: Spread Of Tmp Resistancementioning

confidence: 98%

Trimethoprim resistance

Huovinen

1987

Antimicrob Agents Chemother

Self Cite

101

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“…This study design has been used to compare selection of drug-resistant bacteria from the fecal flora by trimethoprim alone versus trimethoprim-sulfamethoxazole (table 6). Collectively, these studies do not provide convincing evidence that trimethoprim alone is more likely to select resistant bacteria than is the combination [53][54][55][56]. However, 3 of the 4 studies showed selection of drug- Seppala et al [40] Studies at the population level not showing an association between prescribing and resistance Three regions of Finland Gram-negative bacteria; urinary isolates; trimethoprim resistance No clear correlation between the use of trimethoprim and the level of resistance was found.…”

Section: Studies Based On Linking Data About Clinical Cultures and Anmentioning

confidence: 99%

Association between Antibiotic Resistance and Community Prescribing: A Critical Review of Bias and Confounding in Published Studies

Steinke¹,

Davey²

2001

CLIN INFECT DIS

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The reported association between antibiotic prescribing and resistance may be subject to bias or confounding. Bias describes any effect at any stage of investigation or inference tending to produce results that depart systematically from the true value. A confounding variable is one that is associated independently with both exposure and outcome. Confounding variables may create an apparent association or mask a real association. Pharmacoepidemiology is the study of the use and the effects of drugs in large numbers of people. We have used standard pharmacoepidemiological methods to investigate sources of bias and confounding in the association between prescribing and resistance. We conclude that the association is statistically valid and that the consistency of evidence supports a cause-effect relationship. Nonetheless, several important sources of bias and confounding must be taken into account in future studies that analyze the impact of prescribing policies on resistance.

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“…SUL alone is ineffective against enterococci (70). Until more evidence is accumulated, TMPSULs or TMP alone should not be used as a first-line drug in the treatment of enterococcal urinary tract infections (107).…”

Section: Spread Of Tmp and Sul Resistancementioning

confidence: 99%