title: "Collateral damage" from cephalosporin or quinolone antibiotic therapy.
abstract: "Collateral damage" is a term used to refer to ecological adverse effects of antibiotic therapy; namely, the selection of drug-resistant organisms and the unwanted development of colonization or infection with multidrug-resistant organisms. The risk of such damage can be assessed for different antibiotic classes by a variety of epidemiologic studies. Cephalosporin use has been linked to subsequent infection with vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, beta-lactam-resistant Acinetobacter species, and Clostridium difficile. Quinolone use has been linked to infection with methicillin-resistant Staphylococcus aureus and with increasing quinolone resistance in gram-negative bacilli, such as Pseudomonas aeruginosa. Neither third-generation cephalosporins nor quinolones appear suitable for sustained use in hospitals as "workhorse" antibiotic therapy.
authors.affiliation: Division of Infectious Disease, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. patersond@msx.dept-med.pitt.edu
authors.forename: David L
authors.initials: DL
authors.lastname: Paterson
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002511:Cephalosporins / Q000009:adverse effects*; D016360:Clostridioides difficile / Q000187:drug effects; D004351:Drug Resistance; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000187:drug effects; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects; D015363:Quinolones / Q000009:adverse effects*; D013211:Staphylococcus aureus / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015363:Quinolones