Do piperacillin/tazobactam and other antibiotics with inhibitory activity against Clostridium difficile reduce the risk for acquisition of C. difficile colonization?

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Anti-Bacterial Agents/*administration & dosage ; Enterocolitis, Pseudomembranous/*drug therapy ; Penicillanic Acid/*analogs & derivatives ; Piperacillin/*administration & dosage; Anti-Bacterial Agents/pharmacology ; Clostridioides difficile/drug effects ; Clostridioides difficile/physiology ; Enterocolitis, Pseudomembranous/etiology ; Feces/microbiology ; Hospitals ; Humans ; Intestines/microbiology ; Microbial Sensitivity Tests ; Penicillanic Acid/administration & dosage ; Penicillanic Acid/pharmacology ; Piperacillin/pharmacology ; Risk Factors ; Tazobactam
    • Abstract:
      Background: Systemic antibiotics vary widely in in vitro activity against Clostridium difficile. Some agents with activity against C. difficile (e.g., piperacillin/tazobactam) inhibit establishment of colonization in mice. We tested the hypothesis that piperacillin/tazobactam and other agents with activity against C. difficile achieve sufficient concentrations in the intestinal tract to inhibit colonization in patients.
      Methods: Point-prevalence culture surveys were conducted to compare the frequency of asymptomatic rectal carriage of toxigenic C. difficile among patients receiving piperacillin/tazobactam or other inhibitory antibiotics (e.g. ampicillin, linezolid, carbapenems) versus antibiotics lacking activity against C. difficile (e.g., cephalosporins, ciprofloxacin). For a subset of patients, in vitro inhibition of C. difficile (defined as a reduction in concentration after inoculation of vegetative C. difficile into fresh stool suspensions) was compared among antibiotic treatment groups.
      Results: Of 250 patients, 32 (13 %) were asymptomatic carriers of C. difficile. In comparison to patients receiving non-inhibitory antibiotics or prior antibiotics within 90 days, patients currently receiving piperacillin/tazobactam were less likely to be asymptomatic carriers (1/36, 3 versus 7/36, 19 and 15/69, 22 %, respectively; P = 0.024) and more likely to have fecal suspensions with in vitro inhibitory activity against C. difficile (20/28, 71 versus 3/11, 27 and 4/26, 15 %; P = 0.03). Patients receiving other inhibitory antibiotics were not less likely to be asymptomatic carriers than those receiving non-inhibitory antibiotics.
      Conclusions: Our findings suggest that piperacillin/tazobactam achieves sufficient concentrations in the intestinal tract to inhibit C. difficile colonization during therapy.
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    • Contributed Indexing:
      Keywords: Clostridium difficile; Colonization; Piperacillin/tazobactam
    • Accession Number:
      0 (Anti-Bacterial Agents)
      87-53-6 (Penicillanic Acid)
      SE10G96M8W (Tazobactam)
      X00B0D5O0E (Piperacillin)
    • Publication Date:
      Date Created: 20160420 Date Completed: 20161213 Latest Revision: 20220317
    • Publication Date:
      20231215
    • Accession Number:
      PMC4835867
    • Accession Number:
      10.1186/s12879-016-1514-2
    • Accession Number:
      27091232