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Antibiotics 2014, 3(1), 49-63; doi:10.3390/antibiotics3010049

Experimental Simulation of the Effects of an Initial Antibiotic Treatment on a Subsequent Treatment after Initial Therapy Failure

1 Laboratory for Molecular Biology and Microbial Food Safety, Swammerdam Institute for Life Sciences, University of Amsterdam, 1098 XH Amsterdam, The Netherlands 2 Department of Global Health-Amsterdam Institute for Global Health and Development and Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands 3 Netherlands Food and Consumer Product Safety Authority, Office for Risk Assessment, 3511 GG Utrecht, The Netherlands
* Author to whom correspondence should be addressed.
Received: 24 October 2013 / Revised: 23 January 2014 / Accepted: 29 January 2014 / Published: 17 February 2014
(This article belongs to the Special Issue Feature Paper 2013)
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Therapy failure of empirical antibiotic treatments prescribed by primary care physicians occurs commonly. The effect of such a treatment on the susceptibility to second line antimicrobial drugs is unknown. Resistance to amoxicillin was rapidly induced or selected in E. coli at concentrations expected in the patient’s body. Strains with reduced susceptibility outcompeted the wild-type whenever antibiotics were present, even in low concentrations that did not affect the growth rates of both strains. Exposure of E. coli to amoxicillin caused moderate resistance to cefotaxime. The combined evidence suggests that initial treatment by amoxicillin has a negative effect on subsequent therapy with beta-lactam antibiotics.
Keywords: therapy failure; resistance development; amoxicillin; cefotaxime therapy failure; resistance development; amoxicillin; cefotaxime
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Feng, Y.; Händel, N.; de Groot, M.H.P.; Brul, S.; Schultsz, C.; ter Kuile, B.H. Experimental Simulation of the Effects of an Initial Antibiotic Treatment on a Subsequent Treatment after Initial Therapy Failure. Antibiotics 2014, 3, 49-63.

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