Susceptibility surveillance among gram-negative bacilli at a cancer center.
We conducted a survey of susceptibility among 758 gram-negative bacilli (GNB; collected from cancer patients over a 3-month period) to commonly used antibiotics. The overall resistance among GNB was least for piperacillin/tazobactam and meropenem (5 and 6%, respectively) followed by cefepime (8%), imipenem (9%), amikacin (12%), ofloxacin (13%), ciprofloxacin, ceftazidime and ticarcillin/clavulanate (14% each), aztreonam (18%) and tobramycin (24%). In comparison to data on antibiotic resistance to ceftazidime, imipenem, ciprofloxacin and aztreonam in similar studies in 1985 and 1994, resistance has significantly increased to all four antibiotic classes. Based on our current study, meropenem, cefepime, imipenem and piperacillin/tazobactam would be the most appropriate choices in our institution for empiric therapy of GNB infections in febrile neutropenic patients.
Jacobson
K
K
The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4095, USA. kjacobso@Notes.MDACC.tmc.edu
Rolston
K
K
Elting
L
L
LeBlanc
B
B
Whimbey
E
E
Ho
D H
DH
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000382:microbiology*; D000077723:Cefepime; D002511:Cephalosporins / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000494:pharmacology; D010878:Piperacillin / Q000494:pharmacology; D000078142:Tazobactam; D013845:Thienamycins / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D013845:Thienamycins; D000077723:Cefepime; D010397:Penicillanic Acid; D000077731:Meropenem; D000078142:Tazobactam; D010878:Piperacillin