Lower antibiotic resistance in intestinal bacteria with forgotten
antibiotic

Date:
October 29, 2021
Source:
Linko"ping University
Summary:
A forgotten antibiotic, temocillin, led to lower selection of
resistant bacteria than the standard treatment for febrile urinary
tract infection.

Thus, temocillin may be useful in treating severe urinary tract
infections that give rise to fever, and contribute to a reduced
spread of resistant bacteria in hospitals.



FULL STORY ==========================================================================
A forgotten antibiotic, temocillin, led to lower selection of resistant bacteria than the standard treatment for febrile urinary tract infection,
in a study published in The Lancet Infectious Diseases. Thus, temocillin
may be useful in treating severe urinary tract infections that give
rise to fever, and contribute to a reduced spread of resistant bacteria
in hospitals.


==========================================================================
The bacterial species Escherichia coli(E. coli) constitutes a large
fraction of the normal bacterial flora in the intestine. But if E. coli
gets into the wrong places in the body, such as the blood or 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 must be admitted
to hospital and treated with intravenous antibiotics.

"It has long been standard procedure to use the antibiotic cefotaxime
for such intravenous treatment. But as time has passed, an increasing
fraction of bacteria have become less susceptible to this antibiotic,
both in Sweden and the rest of the world, and this has made it necessary
to seek an alternative," says Haakan Hanberger, professor at Linko"ping University and consultant in infectious diseases at Linko"ping University Hospital. He has been principal investigator and medically responsible
for the study.

The study now published is the result of the Public Health Agency of
Sweden being requested by the Swedish government to study how already
existing antibiotics can be used in the best way. The researchers have investigated temocillin, a member of the penicillin group of antibiotics
that has been known for several 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, since it reduces the risk that the treatment will act against the normal intestinal bacterial flora. 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 infection that gave rise
to fever, also known as pyelonephritis, that required intravenous
antibiotics.

"We saw clearly that the intestinal flora was less affected in the group treated with temocillin. The main reason for this is that temocillin
gives less selection of resistant intestinal bacteria," says Charlotta
Edlund, professor of microbiology and specialist investigator at the
Public Health Agency of Sweden.

The clinical effect of temocillin was as good as the standard treatment
with cefotaxime, and the undesired effects were equivalent. The fact that temocillin is less aggressive against the bacterial flora in the intestine suggests that starting to use this forgotten antibiotic for urinary
tract infections will have advantages for both patients and society.

"The consequence will be that we see less selection of resistant
intestinal bacteria in hospitals, which may contribute to reducing hospital-related infections from these bacteria," says Haakan Hanberger.

The study has been funded by the Public Health Agency of Sweden within
the framework of a commission from the Swedish government.

========================================================================== Story Source: Materials provided by Linko"ping_University. Original
written by Karin So"derlund Leifler. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Charlotta Edlund, Anders Ternhag, Gunilla Skoog Staahlgren, Petra
Edquist, AAse O"stholm Balkhed, Simon Athlin, Emeli Maansson, Maria
Tempe', Jakob Bergstro"m, Christian G Giske, Haakan Hanberger,
Charlotta Edlund, Anders Ternhag, Gunilla Skoog Staahlgren, Petra
Edquist, AAse O"stholm Balkhed, Simon Athlin, Emeli Maansson, Maria
Tempe', Jakob Bergstro"m, Christian G Giske, Daniel Holmstro"m,
Anna-Karin Lindgren, Gisela Otto, Maria Furberg, Johan Fa"lt,
Elin Hedman, Haakan Hanberger.

The clinical and microbiological efficacy of temocillin versus
cefotaxime in adults with febrile urinary tract infection, and
its effects on the intestinal microbiota: a randomised multicentre
clinical trial in Sweden.

The Lancet Infectious Diseases, 2021; DOI:
10.1016/S1473-3099(21)00407-2 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/10/211029074859.htm

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