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

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

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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)
View Full-Text   |   Download PDF [896 KB, 18 February 2014; original version 17 February 2014]   |   Browse Figures

Abstract

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 which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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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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