Lower antibiotic resistance in intestinal bac
A forgotten antibiotic, temocillin, led to a lower sample of resistant bacteria than the standard treatment for febrile urinary tract infection, in a study published in Lancet infectious diseases. Thus, temocillin may be useful in the treatment of severe urinary tract infections which give rise to fever, and contribute to the reduction of the spread of resistant bacteria in hospitals.
Bacterial species Escherichia coli (E. coli) constitutes a large part of the normal bacterial flora in the intestine. However, if E. coli enters the wrong places in the body, such as the blood or the urinary tract, it can cause serious illness. E. coli is the most common cause of urinary tract infections. These can often be treated with antibiotics in tablet form, but some patients become so ill that they have to be hospitalized and treated with intravenous antibiotics.
It has long been standard practice to use the antibiotic cefotaxime for such intravenous treatment. But as time has passed, an increasing proportion of the bacteria have become less susceptible to this antibiotic, both in Sweden and the rest of the world, and this has made it necessary to look for an alternative “, says Håkan Hanberger, professor at Linköping University and consultant in infectious diseases at Linköping University Hospital. He has been the principal investigator and medically responsible for the study.
The now published study is the result of the Swedish Public Health Agency being commissioned by the Swedish government to study how existing antibiotics can be used in the best way. Researchers have studied temocillin, a member of the penicillin group of antibiotics that has been known for decades. It is used in some other European countries, but is not marketed in Sweden. Temocillin acts specifically against E. coli and other intestinal bacteria that can cause urinary tract infections. It is positive that temocillin does not have a broad effect against many different bacteria, as it reduces the risk of the treatment acting against the normal bacterial flora in the intestine. This led the researchers to investigate whether temocillin gives less resistance among intestinal bacteria than treatment with the standard antibiotic cefotaxime.
They studied 152 patients with urinary tract infections that gave rise to fever, also known as pyelonephritis, which required intravenous antibiotics.
“We clearly saw that the intestinal flora was less affected in the group treated with temocillin. The main reason for this is that temocillin provides a smaller selection of resistant intestinal bacteria “, says Charlotta Edlund, professor of microbiology and specialist researcher at the Swedish Public Health Agency.
The clinical effect of temocillin was as good as the standard treatment with cefotaxime, and the adverse effects were equivalent. The fact that temocillin is less aggressive against the bacterial flora in the gut indicates that it will be beneficial for both patients and society to start using this forgotten antibiotic for urinary tract infections.
– The consequence is that we see a smaller selection of resistant intestinal bacteria in hospitals, which can help reduce hospital-related infections from these bacteria, says Håkan Hanberger.
The study was funded by the Swedish Public Health Agency within the framework of an assignment from the Swedish government.
The article: “The clinical and microbiological effect of temocillin versus cefotaxime in adults with febrile urinary tract infection, and its effects on the intestinal microbiota: a randomized multicenter clinical trial in Sweden”, Charlotta Edlund, Anders Ternhag, Gunilla Skoog Ståhlgren, Petra Edquist, Åse Östholm Balkhed, Simon , Emeli Månsson, Maria Tempé, Jakob Bergström, Christian G Giske and Håkan Hanberger, (2021), Lancet Infect Dis, published online on October 28, 2021, doi: https://doi.org/10.1016/S1473-3099(21)00407-2
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00407-2/fulltext
Newspaper
Lancet infectious diseases
Method of research
Randomized controlled / clinical trial
Research topic
people
Article title
The clinical and microbiological effect of temocillin versus cefotaxime in adults with febrile urinary tract infection, and its effects on the intestinal microbiota: a randomized multicenter clinical study in Sweden
Date of publication of the article
October 28, 2021
COI statement
The authors do not declare competing interests.
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