{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:33:23Z","timestamp":1790289203867,"version":"4.1.0"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2005,8,1]],"date-time":"2005-08-01T00:00:00Z","timestamp":1122854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2005,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Bowel colonization with resistant bacteria can develop in patients receiving broad-spectrum antimicrobial therapy. We compared the impact of two antimicrobial regimens often used to treat intraabdominal infections on susceptibility patterns of bowel flora at the end of therapy. In a double-blind clinical trial, adults with complicated intraabdominal infection requiring surgery were randomized to receive piperacillin-tazobactam (3.375 g every 6 h) or ertapenem (1 g once a day) for 4 to 14 days. Rectal swabs were obtained at baseline and at the end of study therapy to determine the acquisition rates of\n            <jats:italic>Enterobacteriaceae<\/jats:italic>\n            resistant to the study drug, extended-spectrum \u03b2-lactamase (ESBL)-producing\n            <jats:italic>Escherichia coli<\/jats:italic>\n            or\n            <jats:italic>Klebsiella<\/jats:italic>\n            species,\n            <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n            resistant to imipenem or piperacillin-tazobactam, and vancomycin-resistant\n            <jats:italic>Enterococcus faecalis<\/jats:italic>\n            or\n            <jats:italic>Enterococcus faecium<\/jats:italic>\n            . Treated patients were assessable for the acquisition of resistant bacteria if appropriate specimens were obtained at both time points.\n            <jats:italic>Enterobacteriaceae<\/jats:italic>\n            resistant to the treatment received were acquired during study therapy by 8\/122 assessable piperacillin-tazobactam recipients (6.6%) compared to 0\/122 assessable ertapenem recipients (\n            <jats:italic>P<\/jats:italic>\n            = 0.007). Neither ESBL-producing\n            <jats:italic>E. coli<\/jats:italic>\n            or\n            <jats:italic>Klebsiella<\/jats:italic>\n            species nor\n            <jats:italic>P. aeruginosa<\/jats:italic>\n            resistant to piperacillin-tazobactam was isolated from patients in either treatment group. Imipenem-resistant\n            <jats:italic>P. aeruginosa<\/jats:italic>\n            was acquired by two of the ertapenem recipients (1.6%) versus zero of the piperacillin-tazobactam recipients (\n            <jats:italic>P<\/jats:italic>\n            = 0.50). Vancomycin-resistant enterococci were acquired during therapy by 8\/125 assessable ertapenem recipients (6.4%) versus 2\/123 assessable piperacillin-tazobactam recipients (1.6%;\n            <jats:italic>P<\/jats:italic>\n            = 0.10). In this study, the acquisition of resistant\n            <jats:italic>Enterobacteriaceae<\/jats:italic>\n            occurred significantly more often in patients treated with piperacillin-tazobactam than in those treated with ertapenem.\n          <\/jats:p>","DOI":"10.1128\/aac.49.8.3217-3221.2005","type":"journal-article","created":{"date-parts":[[2005,7,27]],"date-time":"2005-07-27T10:52:45Z","timestamp":1122461565000},"page":"3217-3221","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":42,"title":["Acquisition of Resistant Bowel Flora during a Double-Blind Randomized Clinical Trial of Ertapenem versus Piperacillin-Tazobactam Therapy for Intraabdominal Infections"],"prefix":"10.1128","volume":"49","author":[{"given":"Mark J.","family":"DiNubile","sequence":"first","affiliation":[{"name":"Merck &amp; Co., West Point, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph W.","family":"Chow","sequence":"additional","affiliation":[{"name":"Merck &amp; Co., West Point, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vilas","family":"Satishchandran","sequence":"additional","affiliation":[{"name":"Merck &amp; Co., West Point, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Polis","sequence":"additional","affiliation":[{"name":"Merck &amp; Co., West Point, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary R.","family":"Motyl","sequence":"additional","affiliation":[{"name":"Merck &amp; Co., West Point, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murray A.","family":"Abramson","sequence":"additional","affiliation":[{"name":"Merck &amp; Co., West Point, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hedy","family":"Teppler","sequence":"additional","affiliation":[{"name":"Merck &amp; Co., West Point, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1086\/502267","volume":"24","year":"2003","unstructured":"Bhalla, A., N. J. Pultz, A. J. Ray, C. K. Hoyen, E. C. Eckstein, and C. J. Donskey. 2003. Antianaerobic antibiotic therapy promotes overgrowth of antibiotic-resistant, gram-negative bacilli and vancomycin-resistant enterococci in the stool of colonized patients. Infect. Control Hosp. Epidemiol.24:644-649.","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.2.185"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/338234"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1086\/422002"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200012283432604"},{"key":"e_1_3_1_7_2","unstructured":"Friedland I. C. Chan H. Giezek M. Motyl G. Woods and M. Shivaprakash. 2003. Isolation of resistant faecal enterics in patients treated with piperacillin-tazobactam vs. ertapenem. 13th Eur. Cong. Clin. Microbiol. Infect. Dis. Glasgow United Kingdom 10-13 May 2003."},{"key":"e_1_3_1_8_2","unstructured":"Friedland I. M. Shivaprakash H. Giezek M. Motyl M. DiNubile and C. Chan. 2003. Emergence of resistant gram-negative bacilli in the bowel of patients treated with ceftriaxone\/metronidazole vs. ertapenem for intraabdominal infections. 3rd Int. Meet. Antimicrob. Chemother. Clin. Pract. (ACCP) Portofino Genoa Italy October 2003."},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.6.1619-1628.2002"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.11.3610-3612.2003"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.115.2.462"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.2.798-800.2005"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/160.2.274"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1086\/338782"},{"key":"e_1_3_1_15_2","unstructured":"Namias N. E. Jensen T. King S. Knight S. Rawlins and M. Abramson. 2005. Efficacy safety and tolerability of intravenous (IV) ertapenem (E) vs. piperacillin\/tazobactam (P\/T) in the treatment of complicated intra-abdominal infections in hospitalized adults. 25th Ann. Meet. SIS and 2nd Joint Meet. SIS-E 5-7 May 2005 Miami Fla."},{"key":"e_1_3_1_16_2","unstructured":"National Committee for Clinical Laboratory Standards. 2001. Performance standards for antimicrobial susceptibility testing 11th informational supplement vol. 21. National Committee for Clinical Laboratory Standards Wayne Pa."},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105103441903"},{"key":"e_1_3_1_18_2","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1001\/archinte.159.13.1467","volume":"159","year":"1999","unstructured":"Ostrowsky, B. E., L. Venkataraman, E. M. D'Agata, H. S. Gold, P. C. DeGirolami, and M. H. Samore. 1999. Vancomycin-resistant enterococci in intensive care units: high frequency of stool carriage during a non-outbreak period. Arch. Intern. Med.159:1467-1472.","journal-title":"Arch. Intern. Med."},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1086\/382690"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.6.2206-2212.2001"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-140-1-200401060-00008"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1086\/514643"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.10.3765-3772.2004"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-136-11-200206040-00013"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkg404"},{"key":"e_1_3_1_26_2","first-page":"235","volume":"237","year":"2003","unstructured":"Solomkin, J. S., A. E. Yellin, O. D. Rotstein, N. V. Christou, E. P. Dellinger, J. M. Tellado, O. Malafaia, A. Fernandez, K. A. Choe, A. Carides, V. Satishchandran, and H. Teppler. 2003. Ertapenem versus piperacillin\/tazobactam in the treatment of complicated intraabdominal infections: results of a double-blind, randomized comparative phase III trial. Ann. Surg.237:235-245.","journal-title":"Ann. Surg."},{"key":"e_1_3_1_27_2","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1086\/502409","volume":"25","year":"2004","unstructured":"Stiefel, U., D. L. Paterson, N. J. Pultz, S. M. Gordon, D. C. Aron, and C. J. Donskey. 2004. Effect of the increasing use of piperacillin\/tazobactam on the incidence of vancomycin-resistant enterococci in four academic medical centers. Infect. Control Hosp. Epidemiol.25:380-383.","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"e_1_3_1_28_2","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1086\/502408","volume":"25","year":"2004","unstructured":"Stiefel, U., N. J. Pultz, M. S. Helfand, and C. J. Donskey. 2004. 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