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Antimicrob Agents Chemother. 1976 December; 10(6): 872-877
Copyright © 1976 American Society for Microbiology. All Rights Reserved.

Comparison of the Epidemiology of Bacterial Resistance to Mecillinam and Ampicillin

J. D. Anderson*, Monica A. Adams, Jane C. Barrington, W. N. Spence and C. A. Shepherd

* Infection Control Laboratory, Clifton Hospital,, University of York, York, YO3 6RD, England
Department of Biology, University of York, York, YO3 6RD, England

ABSTRACT

Mecillinam is a new type of ß-lactam antibiotic (an amidinopenicillanic acid) that is particularly active against Enterobacteriaceae and is taken orally as in the form of an ester, pivmecillinam. Assessment of any new antibiotic should include a survey of levels of bacterial resistance and investigation of its capacity to select resistant organisms or harm the commensal flora. Antibiotic resistance patterns of 2,000 Enterobacteriaceae isolated from the urine of patients with significant urinary tract infections were therefore determined. Mecillinam-resistant Enterobacteriaceae were found to be much less common than ampicillin-amoxycillin-resistant organisms both in the community and in hospital patients. Most ampicillin-resistant Enterobacteriaceae from infected urines were susceptible to mecillinam, but the relatively rare mecillinam-resistant organisms were usually resistant to ampicillin and cephaloridine. The fecal flora of 26 healthy volunteers who served as controls or were given repeated courses of therapeutic doses of either ampicillin or pivmecillinam was studied. Pivmecillinam had only a transient effect on the aerobic fecal flora and in contrast to ampicillin did not increase populations of resistant Enterobacteriaceae, which would be a potential hazard to the patient and contaminate the environment.

Antimicrob Agents Chemother. 1976 December; 10(6): 872-877
Copyright © 1976 American Society for Microbiology. All Rights Reserved.





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