No significant difference between ceftriaxone and cefotaxime in the emergence of antibiotic resistance in the gut microbiota of hospitalized patients: A pilot study.
Aged
Aged, 80 and over
Anti-Bacterial Agents
/ therapeutic use
Cefotaxime
/ therapeutic use
Ceftriaxone
/ therapeutic use
Drug Resistance, Bacterial
Feces
/ microbiology
Female
Gastrointestinal Microbiome
/ drug effects
Gram-Negative Bacteria
/ drug effects
Hospitalization
Humans
Male
Microbial Sensitivity Tests
Pilot Projects
Prospective Studies
Extended spectrum beta-lactamase
Gut microbiota
Third generation cephalosporin
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
27
11
2020
revised:
05
01
2021
accepted:
11
01
2021
pubmed:
17
1
2021
medline:
11
5
2021
entrez:
16
1
2021
Statut:
ppublish
Résumé
Ceftriaxone and cefotaxime share a similar antibacterial spectrum and similar indications but have different pharmacokinetic characteristics. Ceftriaxone is administered once daily and 40% of its clearance is by biliary elimination, whereas cefotaxime requires three administrations per day and shows less than 10% biliary elimination. The high biliary elimination of ceftriaxone suggests a greater impact of this antibiotic on the gut microbiota than cefotaxime. The objective of this study was to compare the impact of ceftriaxone and cefotaxime on the gut microbiota. A prospective clinical trial was performed that included 55 patients treated with intravenous ceftriaxone (1 g/24 h) or cefotaxime (1 g/8 h) for at least 3 days. Three fresh stool samples were collected from each patient (days 0, 3, and 7 or at the end of intravenous treatment) to assess the emergence of third-generation cephalosporin (3GC)-resistant Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa, toxigenic Clostridioides difficile, and vancomycin-resistant enterococci. The emergence of 3GC-resistant gram-negative enteric bacilli (Enterobacteriaceae) (5.9% vs 4.7%, p > 0.99), Enterococcus spp, and non-commensal microorganisms did not differ significantly between the groups. Both antibiotics reduced the counts of total gram-negative enteric bacilli and decreased the cultivable diversity of the microbiota, but the differences between the groups were not significant. No significant difference was observed between ceftriaxone and cefotaxime in terms of the emergence of resistance.
Sections du résumé
BACKGROUND
BACKGROUND
Ceftriaxone and cefotaxime share a similar antibacterial spectrum and similar indications but have different pharmacokinetic characteristics. Ceftriaxone is administered once daily and 40% of its clearance is by biliary elimination, whereas cefotaxime requires three administrations per day and shows less than 10% biliary elimination. The high biliary elimination of ceftriaxone suggests a greater impact of this antibiotic on the gut microbiota than cefotaxime. The objective of this study was to compare the impact of ceftriaxone and cefotaxime on the gut microbiota.
METHODS
METHODS
A prospective clinical trial was performed that included 55 patients treated with intravenous ceftriaxone (1 g/24 h) or cefotaxime (1 g/8 h) for at least 3 days. Three fresh stool samples were collected from each patient (days 0, 3, and 7 or at the end of intravenous treatment) to assess the emergence of third-generation cephalosporin (3GC)-resistant Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa, toxigenic Clostridioides difficile, and vancomycin-resistant enterococci.
RESULTS
RESULTS
The emergence of 3GC-resistant gram-negative enteric bacilli (Enterobacteriaceae) (5.9% vs 4.7%, p > 0.99), Enterococcus spp, and non-commensal microorganisms did not differ significantly between the groups. Both antibiotics reduced the counts of total gram-negative enteric bacilli and decreased the cultivable diversity of the microbiota, but the differences between the groups were not significant.
CONCLUSION
CONCLUSIONS
No significant difference was observed between ceftriaxone and cefotaxime in terms of the emergence of resistance.
Identifiants
pubmed: 33453395
pii: S1201-9712(21)00035-7
doi: 10.1016/j.ijid.2021.01.025
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Ceftriaxone
75J73V1629
Cefotaxime
N2GI8B1GK7
Types de publication
Clinical Trial
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
617-623Informations de copyright
Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.