title: [Collateral damage of cephalosporins and quinolones and possibilities for control].
abstract: BACKGROUND
  The occurrence of multidrug-resistant microorganisms is associated with an extended and long-term use of broad-spectrum antibiotics. Indeed, this may lead to a colonization and even to an infection of the patient, which is called collateral damage. Moreover, the risk for collateral damage can be assessed for different antibiotic classes. OCCURRENCE OF MULTIDRUG-RESISTANT MICROORGANISMS: The use of cephalosporins may induce a subsequent infection with vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, beta-lactam-resistant Acinetobacter species, and Clostridium difficile. Quinolones are associated with a subsequent infection with methicillin-resistant Staphylococcus aureus and with increasing resistance in gram-negative bacilli, such as Pseudomonas aeruginosa.
  
  
  CONCLUSIONS
  To avoid the occurrence of multidrug-resistant microorganisms, a strict indication and time-limited use (e.g., 1 week) of antibiotics are required, as already established in the guidelines for infection.
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Essen, Germany. fuat.saner@uni-due.de
authors.forename: Fuat H
authors.initials: FH
authors.lastname: Saner
authors.forename: Ali
authors.initials: A
authors.lastname: Canbay
authors.forename: Guido
authors.initials: G
authors.lastname: Gerken
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Broelsch
mesh_terms: D000150:Acinetobacter / Q000187:drug effects; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002511:Cephalosporins / Q000009:adverse effects* / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000187:drug effects; D003692:Delayed-Action Preparations; D004352:Drug Resistance, Microbial; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D016983:Enterococcus / Q000187:drug effects; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D015363:Quinolones / Q000009:adverse effects* / Q000627:therapeutic use; D020713:Vancomycin Resistance / Q000187:drug effects; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D002511:Cephalosporins; D003692:Delayed-Action Preparations; D015363:Quinolones; D001618:beta-Lactamases