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Bacteria
May Be Showing
Resistance To
New Antibiotic
NEW
YORK (Reuters Health) - A year-old antibiotic designed to stem
the tide of certain treatment-resistant infections is already
showing chinks in its armor, according to a new report.
The drug linezolid
is used to treat Enterococcus faecium (E. faecium) infections
that are resistant to the old standby antibiotic vancomycin. The
hope has been that the new drug would help tackle the growing
problem of vancomycin-resistant enterococci infections in US hospitals.
But in the April 14th issue of The Lancet, Chicago doctors report
on five cases in which patients' infections became resistant to
linezolid, as well.
Antibiotic
resistance is a major problem worldwide, and hospitals are ground
zero since infections and antibiotics are part of everyday life
in these settings. Bacteria have an innate ability to mutate,
and when they are repeatedly exposed to an antibiotic, they learn
to change themselves in order to evade the drug. Bugs that cause
diseases such as pneumonia, tuberculosis and meningitis have learned
to outsmart standard treatments. Without new drugs, experts fear
some bacterial infections will become untreatable.
Before 1989,
no US hospitals had experienced vancomycin-resistant E. faecium
infections. By 1993, however, more than 10% of these infections
acquired in hospitals were resistant to treatment. Linezolid was
approved in April 2000 for the treatment of vancomycin-resistant
E. faecium.
The drug is
reported to fight back two thirds of vancomycin-resistant infections,
according to study author Dr. John P. Quinn and his colleagues
at the University of Illinois College of Medicine in Chicago.
However, in the last 3 months of 2000, the researchers found five
cases of linezolid-resistant E. faecium.
Of the five
patients, three had initially improved on linezolid. Four were
transplant patients, and all had been treated with long courses
of the drug--which increases the chances that resistance will
develop.
According
to Quinn and his colleagues, they now test bacterial samples from
patients to see whether their infections will likely be susceptible
to linezolid before starting them on the antibiotic.
The researchers
``encourage'' all doctors to do the same at the start of patients'
therapy for vancomycin-resistant infections.
SOURCE:
The Lancet 2001;357:1179.
Reference
Source 89
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