The addition of enteral to parenteral antimicrobials may prolong antibiotic era
1School of Clinical Sciences, University of Liverpool
2,Department of Clinical and Molecular Microbiology Cinical Hospital Cente Zagreb
3Department of Anaesthesiology and Intensive Care,Cinical Hospital Cente Zagreb
4Department of Intensive Care University Hospital Getafe, Madrid
DOI: 10.22514/SV41.042009.1 Vol.4,Issue 1,April 2009 pp.6-9
Published: 09 April 2009
Resistance to parenteral antimicrobials generally occurs within two years after introduction into general use. The site where de novo resistance develops has been acknowledged to be the gut. Overgrowth of abnormal flora, defined as 105 potential pathogens per g of faeces is a risk factor for resistance following increased spontaneous mutation leading to polyclonality and antimicrobial resistance. As parenteral antimicrobials generally fail to eradicate the abnormal carrier state in overgrowth concentrations due to sub-lethal concentrations in bile and mucus the enteral antimicrobials polymyxin/tobramycin aiming at converting the abnormal carrier state into normal carriage, are the essential component of selective decontamination of the digestive tract (SDD), because they eradicate carriage and overgrowth including resistant mutants, maintaining the usefulness of parenteral antimicrobials.
normal carriage, abnor-mal carriage, overgrowth, mutation, polyclonality, resistance, selective decontamination of the digestive tract, parenteral antimicrobials, ente-ral antimicrobials
HENDRIK K.F. VAN SAENE,NIA TAYLOR,SMILJA KALENIĆ,MLADEN PERIĆ,MIGUEL ANGEL DE LA CAL. The addition of enteral to parenteral antimicrobials may prolong antibiotic era. Signa Vitae. 2009. 4(1);6-9.
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