Emergence of Ciprofloxacin Resistance in Escherichia coli Isolates after Widespread Use of Fluoroquinolones

Antibiotic prophylaxis with meropenem after allogeneic stem cell transplantation

“…First of all, an elevated risk for Gram-positive infections has been noted in several trials. 19 Furthermore, a major concern is that quinolone prophylaxis may increase the risk for developing infections with resistant bacteria as reported in several studies carried out in patients treated with conventional chemotherapy, 17,18,[20][21][22][23] which showed that patients receiving fluoroquinolone prophylaxis rapidly become colonized with quinolone-resistant E. coli and coagulase-negative staphylococci. In this sense, two oncology units who gave quinolone prophylaxis have documented the nosocomial spread of fluoroquinolone-resistant coagulase-negative staphylococci.…”

“…34 Interestingly, in our study, no meropenem-resistant bacteria has been isolated, suggesting that to start prophylaxis only when granulocyte counts are o500/mm 3 , that is, during the period of higher risk of infection, minimizes the number of days of exposure to the drug and reduces the risk of developing infections with resistant bacteria, as reported in several studies using other approaches. [18][19][20][21][22][23] Nevertheless, this approach should be monitored carefully and, in the absence of fever, meropenem should be discontinued when 4500 granulocytes/mm 3 are reached in order to minimize the days of exposure to the antibiotic and to avoid multiresistant bacteria. In addition, we have not observed an increased risk for Gram-positive infections among patients receiving prophylaxis with meropenem, nor an increased risk of fungal infections as suggested by both culture analysis and the similar number of days of antifungal therapy required for patients whether or not they received prophylaxis.…”

“…[9][10][11][12][13][14][15][16] Nevertheless, the effect of antibiotic prophylaxis on clinical outcome remains controversial with respect to the occurrence of Grampositive bacterial infections, [14][15][16] clinically documented infections 10 and death. 15,16 Furthermore, some studies have reported an increased risk for developing infections with resistant bacteria [17][18][19][20][21][22][23] among patients receiving quinolone prophylaxis.…”

Factores asociados al desarrollo de infección urinaria de origen comunitario causada por Escherichia coli resistente a fluoroquinolonas

“…En ese sentido, Ena y cols. 34 observaron, concomitantemente con la triplicación en el consumo de FQ, un aumento en la tasa de resistencia a FQ en E. coli, de 3 a 20%.…”

Wagging the Dog: Antibiotic Use and the Emergence of Resistance

“…Indeed, it has been noted that the prevalence of resistance to fluoroquinolone antibiotics has increased as the use of these agents has become more widespread, even among more intrinsically susceptible Enterobacteriaceae such as E. coli. 11 Furthermore, prior receipt of a fluoroquinolone antibiotic has been noted to be an independent risk factor for fluoroquinolone-resistant E. coli UTIs. 12 The ramifications of increasing fluoroquinolone resistance would be grave given the many clinical situations in which these agents are currently used.…”