The addition of enteral to parenteral antimicrobials may prolong antibiotic era

Resistance to parenteral antimicrobials generally occurs within two years after introduction into general use. The site where de novo resistance develops has been acknowledged to be the gut. Overgrowth of abnormal flora, defined as 105 potential pathogens per g of faeces is a risk factor for resista...

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Bibliographic Details
Published inSigna vitae Vol. 4; no. 1; p. 6
Main Authors Van Saene, Hendrik K.F, Taylor, Nia, Kalenić, Smilja, Perić, Mladen, de la Cal, Miguel Angel
Format Journal Article
LanguageEnglish
Published Pharmamed Mado Ltd 01.04.2009
Subjects
abnormal carriage
enteral antimicrobials
mutation
normal carriage
overgrowth
parenteral antimicrobials
polyclonality
resistance
selective decontamination of the digestive tract
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Summary:Resistance to parenteral antimicrobials generally occurs within two years after introduction into general use. The site where de novo resistance develops has been acknowledged to be the gut. Overgrowth of abnormal flora, defined as 105 potential pathogens per g of faeces is a risk factor for resistance following increased spontaneous mutation leading to polyclonality and antimicrobial resistance. As parenteral antimicrobials generally fail to eradicate the abnormal carrier state in overgrowth concentrations due to sub-lethal concentrations in bile and mucus the enteral antimicrobials polymyxin/tobramycin aiming at converting the abnormal carrier state into normal carriage, are the essential component of selective decontamination of the digestive tract (SDD), because they eradicate carriage and overgrowth including resistant mutants, maintaining the usefulness of parenteral antimicrobials.
Bibliography:36030
ISSN:1334-5605
1845-206X
DOI:10.22514/SV41.042009.1