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Zur Antibiotikaresistenz von anaeroben Bakterien

Antibiotic resistance of anaerobic bacteria

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Zusammenfassung

Orientierende Daten über die allgemeine Resistenzsituation bei anaeroben Bakterien werden benötigt, da Einzeltestungen wegen der langen Generationszeit anaerober Keime und wegen methodischer Schwierigkeiten kaum therapiegerecht erstellt werden können. Nach MHK-Bestimmungen gelten beiClostridium perfringens Penicillin G und die Tetracycline als Mittel der Wahl; auch neuere Cephalosporine sind gut aktiv. Bei anderen Clostridienspezies muß jedoch mit Resistenzen gerechnet werden. Beta-Laktam-Antibiotika zeigen gute Aktivitäten gegenPeptococcaceae, zu beachten ist aber die Entwicklung einer Clindamycin-Resistenz. Die guteIn-vitro-Wirksamkeit von Tetracyclinen, Clindamycin und Erythromycin gegenüberPropionibacterium acnes hat sich in der Praxis bei der systemischen und lokalen Therapie der Acne vulgaris bestätigt. Im Gegensatz zu den grampositiven Anaerobiern sind gegen die gramnegativen Stäbchen derBacteroides-Gruppe nur wenige Penicillin- und Cephalosporin-Derivate ausreichend aktiv. Bei den neueren Tetracyclinen, bei Nitroimidazolderivaten und bei Lincomycinen kommen vereinzelte Resistenzen vor. Dennoch dürfen diese Substanzen auch weiterhin als Standardtherapeutika bei Infektionen mit gramnegativen anaeroben Bakterien gelten; auf die gute Cefoxitin-Aktivität sei hingewiesen.

Summary

Reference data on the overall resistance patterns of anaerobic bacteria are needed since in individual clinical cases susceptibility testing is complicated by the long generation time and difficulties of test conditions. Benzylpenicillin and tetracyclines are the drugs of choice againstClostridium perfringens. Newer cephalosporins are also active, whereas other Clostridium species have been found resistant. Beta-lactam antibiotics show high activity againstPeptococcaceae; resistance to clindamycin should be noted, however. The goodin vitro activity of tetracyclines, clindamycin and erythromycin againstPropionibacterium acnes could be confirmed in the systemic and local therapy of acne vulgaris. In contrast to gram-positive anaerobic bacteria, only some penicillin and cephalosporin derivatives are sufficiently active against gram-negative rods of theBacteroides group. Sporadic resistance is seen to the newer tetracyclines, nitroimidazole compounds and to lincomycins. Nevertheless, these substances must be considered as standard therapeutics for infections caused by anaerobic gram-negative bacteria. It should be mentioned that cefoxitin may offer new therapeutic possibilities.

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  1. Hygiene-Institut der Universität, Goldenfelsstraße 21, D-5000, Köln 41, W. Germany

    W. Niederau,  U. Höffler &  G. Pulverer

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  1. W. Niederau
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  2. U. Höffler
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  3. G. Pulverer
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Niederau, W., Höffler, U. & Pulverer, G. Zur Antibiotikaresistenz von anaeroben Bakterien. Infection 10, 177–183 (1982). https://doi.org/10.1007/BF01640772

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