Consequences of Antimicrobial Chemotherapy: Overgrowth, Resistance, and Virulence
The right antibiotic, given at the right time and in the correct dose, can cure infection and save lives. Unfortunately, these drugs cause adverse effects, which sometimes make things worse. These may be due to resistant organisms that overgrow in response to a course of antibiotics, or they may be due to the fact that the original pathogen was not eradicated and continues to cause a problem. It is even possible that the original pathogen actually becomes more virulent following exposure to antibiotics. This article reviews the evidence that getting it wrong regarding antibiotic therapy creates more problems for individual patients as well as encouraging antibiotic resistance for future patients.
KeywordsStaphylococcus Aureus Antimicrob Agent Antimicrobial Chemotherapy Virulence Determinant Fusidic Acid
Unable to display preview. Download preview PDF.
- Anonymous. 1999. Four paediatric deaths from community-acquired MRSA— Minnesota and North Dakota, 1997–1999. MMWR 48:707–10.Google Scholar
- Gabello, M., and Iglewski, B.H. 1991. Cloning and characterization of the Pseudomonas aeruginosa lasR gene, a transcriptional activator of elastase production. J Bacteriol 173: 3000–9.Google Scholar
- Klugman, K.P. 2003. Implications for antimicrobial prescribing of strategies based on bacterial eradication. Int J Infect Dis 7 (Suppl 1): S27–31.Google Scholar
- LeBlanc, L., Pepin, J., Toulouse, K., Ouellette, M.-F., Coulombe, M.-A., Corriveau, M.P., and Alary, M.-E. 2006. Fluoroquinolones and risk for methicillin-resistant Staphylococcus aureus, Canada. Emerg Infect Dis 12. Available from http://www.cdc.gov/ncidod/EID/vol12no09/06-0397.htm (last accessed 14 September 2006).
- Lorian, V., and Gemmell, G.C. 1991. Effect of low antibiotic concentrations on bacteria: Effects on ultrastructure, virulence, and susceptibility to immunodefenses, in Lorian, V. (ed). Antibiotics in Laboratory Medicine. Baltimore, Williams & Wilkins, pp. 493–555.Google Scholar
- Ohlsen, K., Ziebuhr, W., Koller, K.-P., Hell, W., Wichelhaus, T.A., and Hacker, J. 1998. Effects of subinhibitory concentrations of antibiotics on alpha-toxin (hla) gene expression of methicillin-sensitive and methicillin-resistant Staphylococcus aureus isolates. Antimicrob Agents Chemother 42: 2817–23.PubMedGoogle Scholar
- Sakoulas, G., Gold, H.S., Cohen, R.A., Venkataraman, L., Moellering, R.C., and Eliopoulos, G.M. 2006. Effects of prolonged vancomycin administration on methicillin-resistant Staphylococcus aureus (MRSA) in a patient with recurrent bacteraemia. J Antimicrob Chemother 57: 699 –704.CrossRefPubMedGoogle Scholar
- Seral, C., Barcia-Macay, M., Migeot-Leclercq, M.P., Tulkens, P.M., and Van Bambeke, F. 2005. Comparative activity of quinolones (ciprofloxacin, levofloxacin, moxifloxacin and garenoxacin) against extracellular and intracellular infection by Listeria monocytogenes and Staphylococcus aureus in J774 macrophages. J Antimicrob Chemother 55: 511–7.CrossRefPubMedGoogle Scholar
- Vaudaux, P.E., Monzillo, V., Francois, P., Lew, D.P., Foster, T.J., and Berger-Bachi, B. 1998. Introduction of the mec element (methicillin resistance) into Staphylococcus aureus alters in vitro functional activities of fibrinogen and fibronectin adhesins. Antimicrob Agents Chemother 42: 564 –70.PubMedGoogle Scholar