+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Replacement of third-generation cephalosporins by piperacillin-tazobactam decreases colonization of extended-spectrum beta-lactamases-producing intestinal Escherichia coli



Replacement of third-generation cephalosporins by piperacillin-tazobactam decreases colonization of extended-spectrum beta-lactamases-producing intestinal Escherichia coli



Zhonghua Nei Ke Za Zhi 46(9): 714-717



To investigate the role of replacement of third-generation cephalosporins by piperacillin-tazobactam (pip-tazo) in influencing the colonization of extended-spectrum beta-lactamases (ESBLs)-producing Escherichia coli (E. coli) in intestinal tract. The study was divided into two phases lasting altogether 9 months, namely the pre-replacement phase (phase I, 3 months) and replacement phase (phase II, 6 months). In the latter phase, third-generation cephalosporins was restricted and replaced by pip-tazo. In phase I and phase IIb (the last 3 months of phase II), clinical data and rectal swab were taken for E. coli isolation as follow: within 24 hrs after admission (baseline screening), every week and 48 hrs before discharge. ESBLs production was detected with double disc test. Acquisition rate of ESBLs-producing E. coli were calculated both in ES1 group (patients' rectal swab collected and tests at least 2 times) and ES2 group (ES1 but with negative ESBLs either at the time of screening on admission or at anytime during the hospital stay). Continuous variable was compared using unpaired t-test and categorical variables was compared using Pearson Chi square test. Fisher's exact test was used in the two phases. In phase IIb, as compared with in phase I, the total consumption of antibiotics other than pip-tazo was reduced by 38.40%, the third-generation cephalosporins consumption was reduced by 70.11%, but pip-tazo consumption was raised by 895.35%. Meanwhile, the acquisition rate of ESBLs-producing E. coli in rectal swab was significantly decreased in phase IIb as compared with phase I (11.4% vs 24.0%) in ES1 group and the same is true in ES2 group (11.8% vs 27.9%). Replacement of third-generation cephalosporin with pip-tazo can reduce colonization of ESBLs--producing E. coli in intestinal tract.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 055496416

Download citation: RISBibTeXText

PMID: 18028795


Related references

Pharmacokinetics-pharmacodynamics of cefepime and piperacillin-tazobactam against Escherichia coli and Klebsiella pneumoniae strains producing extended-spectrum beta-lactamases: report from the ARREST program. Antimicrobial Agents and ChemoTherapy 47(5): 1643-1646, 2003

Comparative assessment of inoculum effects on the antimicrobial activity of amoxycillin-clavulanate and piperacillin-tazobactam with extended-spectrum beta-lactamase-producing and extended-spectrum beta-lactamase-non-producing Escherichia coli isolates. Clinical Microbiology and Infection 16(2): 132-136, 2010

Pharmacokinetics-Pharmacodynamics of Cefepime and Piperacillin- Tazobactam against Escherichia coli and Klebsiella pneumoniae Strains Producing Extended-Spectrum -Lactamases: Report from the Arrest Program. Antimicrobial Agents and Chemotherapy 47(5): 1643-1646, 2003

Impact of the MIC of Piperacillin-Tazobactam on the Outcome of Patients with Bacteremia Due to Extended-Spectrum-beta-Lactamase-Producing Escherichia coli. 2013

Clinical correlation of the CLSI susceptibility breakpoint for piperacillin- tazobactam against extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella species. Antimicrobial Agents and ChemoTherapy 50(6): 2244-2247, 2006

Effects of imipenem-cilastatin, ertapenem, piperacillin-tazobactam, and ceftriaxone treatments on persistence of intestinal colonization by extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae strains in mice. Antimicrobial Agents and ChemoTherapy 51(8): 3044-3045, 2007

Characterization of beta-lactamases in three collections of E coli and K pneumoniae as related to susceptibility to piperacillin/tazobactam and other extended spectrum beta lactams. Abstracts of the General Meeting of the American Society for Microbiology 95: 156, 1995

In the literature. Piperacillin-tazobactam and extended-spectrum β-lactamase--producing Escherichia coli. Clinical Infectious Diseases 57(10): Iii-Iiv, 2014

Randomized controlled trial of piperacillin-tazobactam, cefepime and ertapenem for the treatment of urinary tract infection caused by extended-spectrum beta-lactamase-producing Escherichia coli. Bmc Infectious Diseases 17(1): 404, 2017

Characterization of beta-lactamases responsible for resistance to extended-spectrum cephalosporins in Escherichia coli and Salmonella enterica strains from food-producing animals in the United Kingdom. Microbial Drug Resistance 10(1): 1-9, 2004

Impact of the MIC of piperacillin-tazobactam on the outcome of patients with bacteremia due to extended-spectrum-β-lactamase-producing Escherichia coli. Antimicrobial Agents and ChemoTherapy 57(7): 3402-3404, 2013

Inoculum Effect on the Efficacies of Amoxicillin-Clavulanate, Piperacillin-Tazobactam, and Imipenem against Extended-Spectrum beta-Lactamase ESBL-Producing and Non-ESBL-Producing Escherichia coli in an Experimental Murine Sepsis Model Experimental Th. 2013

Proposed breakpoint of piperacillin/tazobactam against extended spectrum β-lactamases producing bacteria in bacteremia. Journal of Infection and ChemoTherapy 23(1): 65-67, 2017

Foreign travel is a major risk factor for colonization with Escherichia coli producing CTX-M-type extended-spectrum beta-lactamases: a prospective study with Swedish volunteers. Antimicrobial Agents and ChemoTherapy 54(9): 3564-3568, 2010

In vitro activity of fourth generation cephalosporins against enterobacteriaceae producing extended-spectrum beta-lactamases. Journal of ChemoTherapy 8(Suppl. 2): 57-62, 1996