[Collateral damage of cephalosporins and quinolones and possibilities for control].

BACKGROUND: The occurrence of multidrug-resistant microorganisms is associated with an extended and long-term use of broad-spectrum antibiotics. Indeed, this may lead to a colonization and even to an infection of the patient, which is called collateral damage. Moreover, the risk for collateral damage can be assessed for different antibiotic classes. OCCURRENCE OF MULTIDRUG-RESISTANT MICROORGANISMS: The use of cephalosporins may induce a subsequent infection with vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, beta-lactam-resistant Acinetobacter species, and Clostridium difficile. Quinolones are associated with a subsequent infection with methicillin-resistant Staphylococcus aureus and with increasing resistance in gram-negative bacilli, such as Pseudomonas aeruginosa.

CONCLUSION: To avoid the occurrence of multidrug-resistant microorganisms, a strict indication and time-limited use (e.g., 1 week) of antibiotics are required, as already established in the guidelines for infection.