Marina M, K Ivanova M, Kantardjiev T
Antimicrobial susceptibility of anaerobic bacteria in bulgaria. [JOURNAL ARTICLE]
Anaerobe 2009 Mar 14.
OBJECTIVES: The antimicrobial susceptibility of anaerobic bacteria isolated from clinical specimens in the referent for Bulgaria anaerobic laboratory was studied in a period of 25 years /1983-2007/.
METHODS: NCCLS - recommended agar dilution methods were used. beta-lactamase activity was determined with nitrocefin discs.
RESULTS: The 29 antimicrobial agents included in the study were divided according to their in vitro activity against the anaerobic isolates into 4 main groups for guiding empirical treatment: 1(st) group of metronidazole, chloramphenicol, meropenem, imipenem and combinations of beta-lactam antibiotics with sulbactam - with high activity and drugs of choice for treatment; 2(nd) group - clindamycin, cefoxitin, carbenicillin /and azlocillin, piperacillin/ - with a good activity and low percent of resistant strains; 3(rd) group - of tetracycline and erythromycin with higher percent of resistant strains including the new macrolides as josamycin, clarithromycin, roxithromycin and azithromycin; 4(th) group - penicillins /ampicillin, amoxicillin, penicillin/ and cephalosporins /cefamandole, cefazolin, cefotaxime and cefoperazone/ - not suitable for treatment of infections including Bacteroides fragilis group strains, with a very high percent of resistant strains, probably due to beta-lactamase activity in most of the strains.
CONCLUSION: A continued updating and a follow-up in the changes of antibiotic susceptibility is necessary in every country as resistance patterns vary not only between geographical regions but even among medical centers and hospitals which may be connected with differences in antibiotic usage in man and animals.
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