Role of ceftazidime dose regimen on the selection of resistant Enterobacter cloacae in the intestinal flora of rats treated for an experimental pulmonary infection
| Autor: | Wil H. F. Goessens, A. Ott, Irma A. J. M. Bakker-Woudenberg, Johan W. Mouton, A. J. Bijl, M. T. ten Kate |
|---|---|
| Přispěvatelé: | Medical Microbiology & Infectious Diseases |
| Rok vydání: | 2007 |
| Předmět: |
Lung Diseases
Male Microbiology (medical) Genotype Klebsiella pneumoniae medicine.drug_class Antibiotics Ceftazidime Microbial Sensitivity Tests Drug Administration Schedule Microbiology Agar plate Drug Resistance Bacterial Enterobacter cloacae medicine Animals Pharmacology (medical) Antibacterial agent Pharmacology biology Enterobacteriaceae Infections biology.organism_classification Enterobacteriaceae Anti-Bacterial Agents Rats Intestines Infectious Diseases Pharmacodynamics medicine.drug |
| Zdroj: | Journal of Antimicrobial Chemotherapy, 59(3), 507-516. Oxford University Press |
| ISSN: | 1460-2091 0305-7453 |
| Popis: | Objectives: The effect of ceftazidime dosing increments and frequency of dosing on the selection of ceftazidime-resistant Enterobacter cloacae in the intestine was studied in rats, during treatment of a pulmonary infection caused by Klebsiella pneumoniae. Methods: Rats with pulmonary infection (n 5 10 per group) received therapy with doses of ceftazidime at 3.1 to 400 mg/kg per day at a frequency of every 6,12 or 24 h for 18 days, starting 24 h after bacterial inoculation of the lung. Emergence of resistance in intestinal E. cloacae was monitored by culturing fresh stool specimens at days 0, 8, 15, 22, 29, 36 and 43 on agar plates with (6.4 mg/L) and without ceftazidime. Pharmacodynamic indices and time within the mutant selection window (MSW) were assessed in infected rats for each regimen. Ceftazidime-resistant E. cloacae mutants were characterized by determination of the β-lactamase activity under cefoxitin-induced and non-induced conditions. Results: A reduction of intestinal ceftazidime-susceptible E. cloacae was observed and showed a significant correlation with the fAUC/MIC at days 8, 15 and 22 and with the fCmaxon days 8, 15, 22, 29 and 36. More rats treated with 12-25 and 50-100 mg/kg per day every 6 h were found colonized with ceftazidime-resistant E. cloacae mutants than animals treated every 12 h or every 24 h. The proportion of rats colonized with ceftazidime-resistant E. cloacae mutants at days 15, 36 and 43 correlated with the time during which ceftazidime plasma concentrations were within the boundaries of the MSW. Only at day 15 was a correlation demonstrated between the fCmaxand significantly fewer rats colonized with ceftazidime-resistant E. cloacae. Ceftazidime-resistant E. cloacae mutants (MIC ≥ 128 mg/L) were characterized as stable derepressed mutants. Conclusions: Colonization with stable derepressed ceftazidime-resistant E. cloacae mutants particularly occurred when rats were exposed to moderate doses of ceftazidime (12-25 or 50-100 mg/kg per day) administered every 6 h. Emergence of resistance was correlated with time within the MSW. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|