Comparative In Vitro Activity of Ofloxacin and Other Antimicrobial Agents Used in Oral Therapy in General Practice

Focht, Josef; Kraus, H.; Nösner, K.

doi:10.2165/00003495-199300453-00029

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…Some believe that the use of these agents in the community acts as an important selection pressure towards resistance [18] and in Japan there has been a 20-30% increase in fluoroquinolone resistance in gram-negative species such as P. aeruginosa [21]. However, a longitudinal study over 5 years in the United Kingdom reported that 91% of P. aeruginosa remained sensitive to ciprofioxacin [22] and in Germany, ofloxacin resistance amongst gram-negative species as a whole totalled less than 4% after 7 years' use [23]. Further, despite the free availability of both ethical and bootleg preparations of norfloxacin and ciprofloxacin in South India, where most of the population harbour trimethoprim-, ~ampicillin-and chloramphenicol-resistant commensals, there was no cross-resistance to fluoroquinolones amongst nalidixic acid-resistant aerobic faecal flora [24a].…”

Section: Prevalence Of Resistancementioning

confidence: 99%

Bacterial resistance to fluoroquinolones: Lessons to be learned

Ball¹

1994

Infection

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Resistance to fluoroquinolone antibacterials has emerged in a limited form, largely amongst certain specific species and often restricted to single clones of these pathogens. Mediated by chromosomal mutation, the major mechanisms are alterations in gyrase subunits and reduced penetration associated with decreased outer membrane protein production. Resistance is most commonly seen to emerge amongst pathogens with higher than average initial MICs, particularly affected species being Pseudomonas aeruginosa and the staphylococci. Resistance is more likely to be encountered when such pathogens are exposed to concentrations at or below the MIC, which may result either from underdosage, the presence of the organism in a sequestered site, e.g. bone or prostate, or from confounding factors such as the presence of pus, indwelling prostheses or interactions which reduce absorption from the gastrointestinal tract. Repetitive use of these agents and continued use of fluoroquinolone precursors, such as nalidixic acid, may also contribute to resistance emergence. Most resistance is appearing amongst hospitalised patients and much of the apparent burden reflects horizontal cross-infection of many patients by a single resistant clone. There is very limited data linking increasing community use of fluoroquinolones with resistance emergence amongst pathogens such as Escherichia coli. In the main, the emergence of resistance can be anticipated and perhaps prevented or avoided for the sorts of risk groups and pathogens described. The use of adequate dosage by appropriate routes of administration in suitable patients and implementation of surveillance procedures for those at risk will minimise such problems. Policies for the effective use of these valuable agents should be part of everyday practice in hospitals.

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Section: Prevalence Of Resistancementioning

confidence: 99%

Bacterial resistance to fluoroquinolones: Lessons to be learned

Ball¹

1994

Infection

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“…These data are very well in agreement with those reported recently by Kresken et al [3,4] who analysed the prevalence of antibiotic resistance in Europe onthe basis of more than 14,000 isolates collected in 12 European countries. On a national basis Focht et al [5] monitored the susceptibilities of _> 45,000 gram-negative and __. 32,000 gram-positive isolates from outpatients and Grimm [16] analyzed the resistance pattern of approximately 300,000 isolates recovered from in-and outpatients during the past 5 years.…”

Section: Introductionmentioning

confidence: 99%

Quinolone resistance inPseudomonas aeruginosa andStaphylococcus aureus. Development during therapy and clinical significance

Dalhoff

1994

Infection

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This review focuses on published information on the experimental as well as clinical data on the emergence of quinolone resistant isolates. In the course of clinical use of fluoroquinolones, only a sporadic emergence of quinolone resistance has been noted. The resistant organisms emerged particularly in certain clinical settings where large numbers of organisms frequently causing chronic infections are present and/or in loci where quinolone concentrations may not be optimal. In terms of occurrence in individuals, quinolone resistance has emerged most frequently in hospitalized and nursing-home patients with identifiable risk factors. Epidemiological studies revealed that in nearly all the cases studied one or one predominating quinolone resistant clone was selected that was horizontally transmitted. Thus, the emergence of quinolone resistance is not due to an independent selection of resistant strains in a number of patients, but to the clonal spread of one strain once it has acquired quinolone resistance. Therefore, the rate of quinolone resistance is very likely to be lower than reported.

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Comparative In Vitro Activity of Ofloxacin and Other Antimicrobial Agents Used in Oral Therapy in General Practice

Cited by 2 publications

References 3 publications

Bacterial resistance to fluoroquinolones: Lessons to be learned

Bacterial resistance to fluoroquinolones: Lessons to be learned

Quinolone resistance inPseudomonas aeruginosa andStaphylococcus aureus. Development during therapy and clinical significance

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