title: [The pneumococcal connection].
abstract: The resistance of gram-negative bacilli is one of the most important areas in modern medicine, however it hasn't been highlighted the role of the third generation cephalosporins and in particularly ceftriaxone in the selection of gram-negative bacilli resistant to these agents. Paradoxically, ceftriaxone, like the rest of the molecules of this generation, whose initial indication were gram- negative infections began to be used as an agent of choice in pneumococcal infections. The broad spectrum activity of this molecule with its favorable pharmacokinetic properties replaces other agents by this antibiotic in the treatment of a wide range of community acquired infections. However, it wasn't considered the action of this cephalosporin on the microbiome, particularly the intestinal flora, which allowed the selection of enterobacteria that by genetic events, especially parental β-lactamases mutations (TEM-1, TEM-2, SHV-1), developed resistance to third-generation cephalosporins. The decreased susceptibility to penicillin in Streptococcus pneumoniae isolates that stimulated the growing use of ceftriaxone, was one of the main drivers for the development of resistance to third-generation cephalosporins in gram-negative bacilli.
authors: Departamento de Medicina Interna, Universidad de Concepción, Chile. pignatio@vtr.net
authors: Sergio
authors: S
authors: Mella
authors: Gisela
authors: G
authors: Riedel
authors: Loreto
authors: L
authors: Twele
authors: Mariana
authors: M
authors: Domínguez
authors: Helia
authors: H
authors: Bello
authors: Gerardo
authors: G
authors: González
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002443:Ceftriaxone / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006801:Humans; D011008:Pneumococcal Infections / Q000188:drug therapy; D013296:Streptococcus pneumoniae / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D002443:Ceftriaxone