The patients were started on third generation cephalosporin
Conclusions: Third generation Cephalosporin
resistance is present in 16.2% of patients with community acquired spontaneous bacterial peritonitis.
Furthermore, uncontrolled use of aztreonam and cephalosporin (Third generation cephalosporin
) results in the mutation in the enzymes and which in turn cause the emerge of ESBL producing pathogens (Grover et al., 2006; Sharma et al., 2013; Kumar et al., 2014).
A systematic review of the literature showed that tazobactam and clavulanic acid are partial inhibitors of KPCs and the hydrolysis of the third generation cephalosporin
is relatively weak in KPCs .
We report a case of typhoid due to Salmonella enteric serovar Typhi which was resistant to all the first line antibiotics as well as fluoroquinolones and third generation cephalosporin
. Hence the patient had to be treated with meropenem, a carbapenem drug which is not usually recommended for the treatment of typhoid fever.
Pneumoniae found resistant to any one of the third generation cephalosporin
should be suspected of being a potential ESBL producer and should be subjected to the double disc synergy test.The use of more than one discs increases the sensitivity of ESBL detection10.
The Infectious Diseases Society of America Clinical Practice Guidelines recommend for methicillin susceptible staph aureus (MSSA), streptococcus or enterobacteriaceae a second or third generation cephalosporin
, quinolone, or carbapenem.
Ceftizoxime is third generation cephalosporin
effective against aerobic gram positive bacteria, gram negative bacilli and anaerobic bacteria.
aeruginosa and the combination of vancomycin and third generation cephalosporin
might not be effective in number cases of bacterial endophthalmitis.
The patient went to the emergency department immediately and was admitted to the intensive care unit where he received intravenous treatment with third generation cephalosporin
(1 g ceftriaxone) and an intramuscular aminoglycoside (800 mg isepamicin).
In our study, resistance to third generation cephalosporin
's was found to coexist with resistance to two or more antibiotics like ampicillin, nalidixic acid, cotrimoxazole, nitrofurantoin, norfloxacin, amikacin as also reported by Subha et al (18) and Duttaroy et al (19) indicating multidrug resistance pattern.