Third-generation cephalosporin resistance in gram-negative bacteria in the community: a growing public health concern

Park, Sun Hee

doi:10.3904/kjim.2014.29.1.27

Cited by 47 publications

(31 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We note that those negative associations do not reach statistical significance in the multivariable model (Table 4). Moreover, prevalence of cephalosporin resistance and the frequency of extended-spectrum beta-lactamase (ESBL) production, including in Gram-negative bacteria is growing [50], and replacement of other antibiotics by cephalosporins might potentially lead to negative effects in the long run. Finally, we found no associations between the proportion of macrolides among all antibiotic prescriptions in the US and rates of mortality with sepsis in adults, which agrees with our earlier findings regarding septicemia hospitalizations [14].…”

Section: Sensitivity Analysis Resultsmentioning

confidence: 99%

Prescribing of different antibiotics, rates of sepsis-related mortality and bacteremia in the US and England, and the utility of antibiotic replacement vs. reduction in prescribing: a cross-sectional study

Goldstein

2019

Preprint

View full text Add to dashboard Cite

Background Antibiotic use contributes to the rates of bacteremia, sepsis and associated mortality, particularly through lack of clearance of resistant infections following antibiotic treatment. At the same time, there is limited information on the effects of prescribing of some antibiotics vs. others on the rates of outcomes related to severe bacterial infections. Methods We looked at associations between the proportions (state-specific in the US; Clinical Commissioning Group (CCG)-specific in England) of different antibiotic types/classes among all prescribed antibiotics in the outpatient setting (oral antibiotics in the US), and rates of outcomes (mortality with sepsis, ICD-10 codes A40-41 present as either underlying or contributing causes of death on a death certificate in different age groups of US adults; E. coli as well as MSSA bacteremia in England) per unit of antibiotic prescribing (defined as the rate of outcome divided by the rate of outpatient prescribing of all antibiotics). Results In the US, prescribing of penicillins was associated with rates of mortality with sepsis for persons aged 75-84y and 85+y between 2014-2015. In England, prescribing of penicillins other than amoxicillin/co-amoxiclav was associated with rates of both MSSA and E. coli bacteremia for the period between financial years 2014/15 through 2017/18. Additionally, multivariable analysis for the US data has also shown an association between the percent of individuals aged 50-64y lacking health insurance, as well as the percent of individuals aged 65-84y who are African-American and rates of mortality with sepsis in the corresponding age groups. Conclusions Our results suggest that prescribing of penicillins is associated with rates of E. coli and MSSA bacteremia in England, and rates of mortality with sepsis in older US adults. Those results, as well as the related epidemiological data suggest that replacement of certain antibiotics, particularly penicillins in the treatment of certain syndromes should be considered for reducing the rates of outcomes related to severe bacterial infections.

show abstract

Section: Sensitivity Analysis Resultsmentioning

confidence: 99%

Prescribing of different antibiotics, rates of sepsis-related mortality and bacteremia in the US and England, and the utility of antibiotic replacement vs. reduction in prescribing: a cross-sectional study

Goldstein

2019

Preprint

View full text Add to dashboard Cite

show abstract

“…We note the high prevalence of resistance to fluoroquinolones for certain syndromes that contribute to the volume of septicemia hospitalizations, like urinary tract infections (UTIs) [27,26]. Additionally, prevalence of cephalosporin resistance and the frequency of extended-spectrum beta-lactamase (ESBL) production, including in Gram-negative bacteria is growing [48]. Macrolide use could potentially contribute to the rates of sepsis as macrolides are commonly prescribed for the treatment of certain syndromes that are major causes of sepsis, notably respiratory diseases, both chronic [49] and acute, including pneumonia [50].…”

Section: Discussionmentioning

confidence: 99%

Levels of outpatient prescribing for four major antibiotic classes and rates of septicemia hospitalization in adults in different US states

Goldstein

Olesen

Karaca

et al. 2018

Preprint

View full text Add to dashboard Cite

Background: Rates of sepsis/septicemia hospitalization in the US have risen significantly during recent years, and antibiotic resistance and use may contribute to those rates through various mechanisms.Methods: We used multivariable linear regression to relate state-specific rates of outpatient prescribing overall for fluoroquinolones, penicillins, macrolides, and cephalosporins between 2011-2012 to state-specific rates of hospitalization with septicemia (ICD-9 codes 038.xx present anywhere on discharge diagnosis) in each of the following age groups of adults: (18-49y, 50-64y, 65-74y, 75-84y, 85+y) reported to the Healthcare Cost and Utilization Project (HCUP) between 2011-2012, adjusting for additional covariates, and random effects associated with the ten US Health and Human Services (HHS) regions.Results: Rates of penicillin prescribing were positively associated with septicemia hospitalization rates in the analyses for persons aged 50-64y, 65-74y, and 74-84y. Percent African Americans in a given age group was positively associated with septicemia hospitalization rates in the analyses for persons aged 75-84y and over 85y. Average minimal daily temperature was positively associated with septicemia hospitalization rates in the analyses for persons aged 18-49y, 50-64y, 75-84y and over 85y. Conclusions: Our results suggest positive associations between the rates of prescribing for penicillins and the rates of sepsis hospitalization in US adults aged 50-84y. Further studies are needed to understand the potential effect of antibiotic replacement in the treatment of various syndromes, such as replacement of fluoroquinolones by other antibiotics, possibly penicillins following the recent US FDA guidelines on restriction of fluoroquinolone use, on the rates of sepsis hospitalization.

show abstract

“…The antibiogram of our study showed that Cephalosporins specially third generation showed 79.71% of resistance which is highest of all is a growing concern for increasing resistance.15 A study done by Park S. et at also showed similar profile of resistance for third generation Cephalosporins. 19 There was highest sensitivity seen with Carbapenems like Meropenem 100% in the antibiogram of the study. The study done by Leisy Azar S. et al also showed the similar pattern for the Carbapenems.…”

Section: Discussionmentioning

confidence: 73%

Antibiotic sensitivity profile of Klebsiella isolates and it’s impact on clinical outcome

Damor

Kubavat

2019

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

Background: Antimicrobials are the greatest discovery of the twentieth century. To limit the emergence and spread of resistance, antibiotic therapy should be adjusted according to the results of microbiological culture. Klebsiella isolates causes various types of infections and the incidence of antibiotic resistance is also high in Klebsiella infections. So, Authors plan this study to analyze how the results of microbiological cultures influence the antibiotic use in the treatment of Klebsiella infections.Methods: It is a record based observational prospective study which assessed the impact of Klebsiella positive culture results on antibiotic prescribing pattern and its impact on clinical outcome. Patients with empirical antibiotic therapy and Klebsiella positive were included and patients with inadequate data were excluded in this study and the data were recorded. Recorded data were entered and analyzed in Microsoft Office Excel-2013. Unpaired student t-test was used to compare the mean duration of hospital stay using Past software (version 3.20).Results: There were total 400 patients in our study. Amikacin was the most common drug (n=202) used as empirical therapy. Empirical antibiotic therapy was changed in 161(40.25%) patients. Meropenem was the most commonly used definitive drug. Mean duration of hospital stay is less in empirical sensitive antibiotic therapy as compared to empirical resistance antibiotic therapy having p value <0.0001 which shows significant difference between two groups showing better clinical outcome.Conclusion: Initial empirical therapy with broad-spectrum antimicrobials is a treatment strategy for severe Klebsiella infections.

show abstract

Third-generation cephalosporin resistance in gram-negative bacteria in the community: a growing public health concern

Cited by 47 publications

References 10 publications

Prescribing of different antibiotics, rates of sepsis-related mortality and bacteremia in the US and England, and the utility of antibiotic replacement vs. reduction in prescribing: a cross-sectional study

Prescribing of different antibiotics, rates of sepsis-related mortality and bacteremia in the US and England, and the utility of antibiotic replacement vs. reduction in prescribing: a cross-sectional study

Levels of outpatient prescribing for four major antibiotic classes and rates of septicemia hospitalization in adults in different US states

Antibiotic sensitivity profile of Klebsiella isolates and it’s impact on clinical outcome

Contact Info

Product

Resources

About