Resistance to antibiotics is the most common factor these days, if the patient develops resistant to high class antibiotics what would be the alternate therapy?? Is it necessary to continue the same to act against gram negative bacteria, in case of third generation cephalosporins?? Please help me in finding the positive and negative prospects assigned with the antibiotic therapy?
The answer to your question depends on many factors, first of all why the third generation cephalosporin was prescribed. Which type of infection and what bacteria are suspected. Second you should clarify better what you mean by a patient develop resistance (during a therapy course or he come back to the physician with a relapse?).
Usually it is unlikely to develop resistance during the therapy, but is more likely that the patient is already infected with resistant strains (you will see it by noting that after an initial improvement in the patient conditions there will be a worsenings after a few days).
In any case, depending on the suspected infectious agents, the doctor may switch to another anti gram-negative drug or an anti MRSA drug, or even an anti anaerobic drug as add on therapy. These are the bacterial infections that are not covered by third generation cephalosporins, i.e. multidrug resistant gram negatives, MRSA and anaerobes. This is true for the majority ofcases but of course as usual there are exceptions.
Dear Stefano Biondi...
Thank you for your answer and for raising the questions to be answered...
1) In our hospital set up, it is most common for any infection (mostly gram negative), the physician go for third generation cephalosporins.
2) I want to know about developing the resistance during therapy course...
In case of resistance it is no need to continue with 3rd generation cephalosporins, you may prescribe aminoglycosides, specifaccally more potent for G negative - Tobramycin and the most potent - Amykacin.
Good luck
How do you know that the drug is resistant, due you go for culture or clinical response
Generally we go for CST, under few circumstances we go for clinical response
If we thick that the child has got excellent presponse we ignore cultures
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