Anaerobic infections: Update on treatment considerations

Drugs

Volumn 70, Issue 7, 2010, Pages 841-858

  Nagy, Elisabeth ^a  

^a UNIVERSITY OF SZEGED   (Hungary)

Author keywords

Anaerobic infections, treatment; Carbapenems, therapeutic use; Cephamycins, therapeutic use; Clindamycin, therapeutic use; Metronidazole, therapeutic use; Moxifloxacin, therapeutic use; Piperacillintazobactam, therapeutic use; Tigecycline, therapeutic use

Indexed keywords

AMOXICILLIN PLUS CLAVULANIC ACID; ANTIBIOTIC AGENT; CARBAPENEM; CEFOXITIN; CLINDAMYCIN; IMIPENEM; MEROPENEM; METRONIDAZOLE; MOXIFLOXACIN; PIPERACILLIN PLUS TAZOBACTAM;

ANAEROBIC BACTERIUM; ANAEROBIC INFECTION; ANTIBIOTIC RESISTANCE; ANTIBIOTIC SENSITIVITY; BACTERIUM CULTURE; BACTERIUM ISOLATE; CLINICAL FEATURE; CORRELATION ANALYSIS; NONHUMAN; OPPORTUNISTIC INFECTION; REVIEW;

ANIMALS; ANTI-BACTERIAL AGENTS; BACTERIA, ANAEROBIC; DRUG RESISTANCE, MULTIPLE, BACTERIAL; GRAM-NEGATIVE ANAEROBIC BACTERIA; GRAM-NEGATIVE BACTERIAL INFECTIONS; GRAM-POSITIVE BACTERIAL INFECTIONS; HUMANS;

EID: 77951707995     PISSN: 00126667     EISSN: 11791950     Source Type: Journal    
DOI: 10.2165/11534490-000000000-00000     Document Type: Review

References (124)

1. Finegold SM, George WL. Anaerobic infections in hu-mans. San Diego (CA): Academic Press, 1989
2. Horz HP, Vianna ME, Gomes BP, et al. Evaluation of universal probes and primer sets for assessing total bacterial load in clinical samples: general implications and practical use in endodontic antimicrobial therapy. J Clin Microbiol 2005; 43: 5332-5337
3. Jousimies-Somer HR, Summanen P, Citron DM, et al., editors. Wadsworth-KTL anaerobic bacteriology manual. 6th ed. Belmont (CA): Star Publishing Company, 2002
4. Slots J, Taubman MA. Contemporary oral microbiology and immunology.St Louis (MO): Mosby-Year Book, 1992
5. Salyers AA, Gupta A, Wang Y. Human intestinal bacteria as reservoirs for antibiotic resistance genes. Trends Micro-biol 2004; 12: 412-416
6. Jousimies-Somer HR, Finegold SM. Problems encountered in anaerobic bacteriology. Rev Infect Dis 1984; 6 Suppl. 1: 45-50
7. Nguyen MH, Yu VL, Morris AJ, et al. Antimicrobial re-sistance and clinical outcome of Bacteroides bacteraemia: findings of a multicenter prospective observational trial. Clin Infect Dis 2000; 30: 870-876
8. Aldridge KE, Ashcraft D, O'Brien M, et al. Bacteremia due to Bacteroides fragilis group: distribution of the species, beta-lactamase production, and antimicrobial susceptibility patterns. Antimicrob Agents Chemother 2003; 47: 148-153
9. Riordan T. Human infection with Fusobacterium necro-phorum (Necrobacillosis) with a focus on Lemierre's syndrome. Clin Microbiol Rev 2007; 20: 622-659
10. Brook I. The role of anaerobic bacteria in chronic sup-purative otitis media in children: implications for medical therapy. Anaerobe 2008; 14: 297-300
11. Marik PE. Aspiration pneumonitis and aspiration pneu-monia. N Engl J Med 2001; 344: 665-671
12. Sweet RL. Role of bacterial vaginosis in pelvic inflamma-tory disease. Clin Infect Dis 1995; 20 Suppl.: S142-8
13. Citron DM, Goldstein EJ, Merriam CV, et al. Bacteriology of moderate-to-severe diabetic foot infections and in vitro activity of antimicrobial agents. J Clin Microbiol 2007; 45: 2819-2828
14. Talan DA, Citron DM, Abrahamian FM, et al. Bacterio-logic analysis of infected dog and cat bites: Emergency Medicine Animal Bite Study Group. N Engl J Med 1999; 340: 85-92
15. Green RJ, Dafoe DC, Raffin TA. Necrotizing fasciitis. Chest 1996; 110: 219-229
16. Levy PY, Fenollar F, Stein A, et al. Finegoldia magna: a forgotten pathogen in prosthetic joint infection rediscovered by molecular biology. Clin Infect Dis 2009; 15: 1244-1247
17. Kuijper EJ, Barbut F, Brazier JS, et al. Update of Clos-tridium difficile infection due to PCR ribotype 027 in Europe, 2008. Euro Surveill 2008; 13: pii:18942
18. Gerding DN. Disease associated with Clostridium difficile infection. Ann Intern Med 1989; 110: 255-257
19. Sears CL, Myers LL, Lazenby A, et al. Enterotoxigenic Bacteroides fragilis. Clin Infect Dis 1995; 20 Suppl.: S142-8
20. Sears CL, Islam S, Saha A, et al. Association of entero-toxigenic Bacteroides fragilis infection with inflammatory diarrhea. Clin Infect Dis 2008; 47: 797-803
21. Wu S, Rhee KJ, Albesiano E, et al. A human colonic commensal promotes colon tumorigenesis via activation of T helper type 17 T cell responses. Nat Med 2009; 15: 1016-1022
22. Hecht DW. Prevalence of antibiotic resistance in anaerobic bacteria: worrisome developments. Clin Infect Dis 2004; 39: 92-97
23. Bieluch VM, Cuchural GJ, Syndman DR, et al. Clinical importance of cefoxitin-resistant Bacteroides fragilis isolates. Diagn Microbiol Infect Dis 1987; 7: 119-126
24. Snydman DR, Cuchural Jr GJ, McDermott L, et al. Cor-relation of various in vitro testing methods with clinical outcomes in patients with Bacteroides fragilis group infections treated with cefoxitin: a retrospective analysis. Antimicrob Agents Chemother 1992; 36: 540-544
25. Dalmau D, Cayouette M, Lamothe F, et al. Clindamycin resistance in the Bacteroides fragilis group: association with hospital-acquired infections. Clin Infect Dis 1997; 24: 874-877
26. Clinical and Laboratory Standards Institute (CLSI). Methods for antimicrobial susceptibility testing of anaerobic bacteria: approved standard [document M11-A7]. 6th ed. Wayne (PA): CLSI 2008
27. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Clinical breakpoints [online]. Available from URL: http://www.srga.org/eucastwt/ MICTAB/[Accessed 2008 Mar 12]
28. Phillips I, King A, Nord CE, et al. Antibiotic sensitivity of Bacteroides fragilis group in Europe. Eur J Clin Microbiol Infect Dis 1992; 11: 292-304
29. King A, Downes J, Nord CE, et al. Antimicrobial suscep-tibility of non-Bacteroides fragilis group anaerobic Gram-negative bacilli in Europe. Clin Microb Infect 1999; 5: 404-416
30. Hedberg M, Nord CE. Antimicrobial susceptibilities of Bacteroides fragilis group isolates in Europe. Clin Micro-biol Infec 2003; 9: 475-488
31. Brazier J, Chmelar D, Dubreuil L, et al. European sur-veillance study on antimicrobial susceptibility of Gram-positive anaerobic cocci. Int J Antimicrob Agents 2008; 31: 316-320
32. Snydman DR, Jacobus NV, McDermott LA, et al. Na-tional survey on the susceptibility of Bacteroides fragilis group: report and analysis of trends for 1997-2000. Clin Infect Dis 2002; 35 Suppl.: S126-34
33. Aldridge KE, Ashkraft D, Cambre K, et al. Multicenter survey of the changing in vitro antimicrobial susceptibilities of clinical isolates of Bacteroides fragilis group, Prevotella, Fusobacterium, Porphyromonas and Peptos-treptococcus species. Antimicrob Agents Chemother 2001; 45: 1238-1243
34. Hecht DW, Lederer L. Effect of choice of medium on the results of the in vitro susceptibility testing of eight antibiotics against the Bacteroides group. Clin Infect Dis 1995; 20 Suppl.: S346-9
35. Giraud-Morin C, Madinier I, Fosse T. Sequence analysis of the cfxA2-like beta-lactamases in Prevotella species. J Antimicrob Chemother 2003; 51: 1293-1296
36. Nagy E, Szoke I, Gacs M, et al. Resistance to beta-lactam antibiotics and beta-lactamase production of Bacteroides, Porphyromonas and Prevotella strain. Acta Microbiol Hun 1995; 42: 287-299
37. Wybo I, Pierard D, Verschraegen I, et al. Third Belgian multi-centre survey of antibiotic susceptibility of anaerobic bacteria. J Antimicrob Chemother 2007; 59: 132-139
38. Nagy E. Changes in the antibiotic resistance of Bacteroides fragilis group strains in Europe: twenty years of experience. 19th [S217] European Congress of Clinical Microbiology and Infectious Diseases; 2009 May 16-19; Helsinki
39. Snydman DR, Jacobus NV, McDermott LA, et al. Multi-center study of in vitro susceptibility of the Bacteroides fragilis group: 1995-1996 with comparison of resistance trends from 1990-1996. Antimicrob Agents Chemother 1999; 43: 2417-2422
40. Behra-Miellet J, Calvet L, Mory F, et al. Antibiotic resis-tance among anaerobic Gram-negative bacilli: lesson from a French multicentric survey. Anaerobe 2003; 9: 105-111
41. Smith CJ, Trible GD, Bayley DP. Genetic elements of Bacteroides species: a moving story. Plasmid 1998; 40: 12-29
42. Snydman DR, Jacobus NV, MyDermott LA, et al. National survey on the susceptibility of Bacteroides fragilis group: report and analysis of trends in the United States from 1997 to 2004. Antimicrob Agents Chemother 2007; 51: 1649-1655
43. Liu CY, Huang YT, Liao CH, et al. Increasing trends in antimicrobial resistance among clinically important anaerobes and Bacteroides fragilis isolates causing noso-comial infections: emerging resistance to carbapenems. Antimicrob Agents Chemother 2008; 52: 3161-3168
44. Fang H, Hedberg M, Edlund C, et al. Characterization of beta-lactam resistant Bacteroides fragilis isolates by use of PCR fingerprinting. Anaerobe 1999; 5: 11-18
45. Garcia N, Gutierrez G, Lorenzo M, et al. Gene context and DNA rearrangements in the carbapenemase locus of division II strains of Bacteroides fragilis. Antimicrob Agents Chemother 2009; 53: 2677-2678
46. Podglajen I, Breuil J, Casin I, et al. Genotypic identifica-tion of two groups within the species Bacteroides fragilis by ribotyping and by analysis of PCR-generated fragment patterns and insertion sequence content. J Bacteriol 1995; 177: 5270-5275
47. Soki J, Urban E, Szoke I, et al. Prevalence of the carbape-nemase gene (cfiA) among clinical and normal flora isolates of Bacteroides species in Hungary. J Med Microbiol 2000; 49: 427-430
48. Edwards R, Hawkyard CV, Garvey MT, et al. Prevalence and degree of expression of the carbapenemases gene (cfiA) among clinical isolates of Bacteroides fragilis in Nottingham, UK. J Antimicrob Chemother 1999; 43: 273-276
49. Yamazoe K, Kato N, Kato H, et al. Distribution of the cfiA gene among Bacteroides fragilis strains in Japan and relatedness of cfiA to imipenem resistance. Antimicrob Agents Chemother 1999; 43: 2808-2810
50. Fang H, Edlund C, Zhang G, et al. Detection of imipenem-resistant and metronidazole-resistant Bacteroides fragilis strains in fecal samples. Clin Microb Infect 1999; 5: 753-758
51. Wexler HM, Halebian S. Alterations to the penicillin-binding proteins in the Bacteroides fragilis group: a mechanism for non-beta-lactamase mediated cefoxitin resistance. J Antimicrob Chemother 1990; 26: 7-20
52. Fang H, Edlund C, Nord CE, et al. Selection of cefoxitin-resistant Bacteroides thetaiotaomicron mutants and mechanisms involved in beta-lactam resistance. Clin Infect Dis 2002; 35 Suppl.: S47-53
53. Hedberg M, Nagy E, Nord CE. Role of penicillin-binding proteins in resistance of Bacteroides fragilis group species to beta-lactam drugs. Clin Infect Dis 1997; 25 Suppl.: S270-1
54. Nagy E, Szoke I, Gacs M, et al. Antibiotic susceptibility of Bacteroides fragilis group strains in Hungary. Anaerobe 1995; 1: 269-274
55. Glupczynski Y, Berhin C, Nizet H. Antimicrobial suscep-tibility of anaerobic bacteria in Belgium as determined by E-test methodology. Eur J Clin Microbiol Infect Dis 2009; 28: 261-267
56. Rasmusen BA, Bush K, Tally FP. Antimicrobial resistance in anaerobes. Clin Infect Dis 1997; 24 Suppl.: S110-20
57. Privitera G, Dublanchet A, Sebald M. Transfer of multiple antibiotic resistance between subspecies of Bacteroides fragilis. J Infect Dis 1979; 139: 97-101
58. Urban E, Soki J, Brazier JS, et al. Prevalence and characterization of nim genes of Bacteroides spp isolated in Hungary. Anaerobe 2002; 8: 175-179
59. Rotimi VO, Khoursheed M, Brazier JS, et al. Bacteroides species highly resistant to metronidazole: an emerging clinical problem? Clin Microbiol Infect 1999; 5: 166-169
60. Brazier JS, Stubbs SLJ, Duerden BI. Metronidazole resistance among clinical isolates belonging to the Bacteroides fragilis group: time to be concerned? J Antimicrob Chemo-ther 1999; 44: 580-581
61. Katsandi A, Avlamis A, Pantazatua A, et al. Dissemination of nim-class genes, encoding nitroimidazole resistance among different species of Gram-negative anaerobic bacteria isolated in Athens, Greece. J Antimicrob Chemo-ther 2006; 58: 705-706
62. Lubbe MM, Stanley K, Chalkley LJ. Prevalence of nim genes in anaerobic/facultative anaerobic bacteria in South Africa. FEMS Microbiol Lett 1999; 1: 79-83
63. Lofmark S, Fang H, Hedberg M, et al. Inducible metronidazole resistance and nim genes in clinical Bacteroides fragilis group isolates. Antimicrob Agents Chemother 2005; 49: 1253-1256
64. Diniz CG, Farias LM, Carvalho MA, et al. Differential gene expression in a Bacteroides fragilis metronidazole-resistant mutant. J Antimicrob Chemother 2004; 54: 100-108
65. Goldstein EJC, Citron DM, Warren YA, et al. In vitro activity of moxifloxacin against 923 anaerobes isolated from human intra-abdominal infections. Antimicrob Agents Chemother 2006; 50: 148-155
66. Golan Y, McDermott LA, Jacobus NV, et al. Emergence of fluoroquinolone resistance among Bacteroides species. J Antimicrob Chemother 2003; 52: 208-213
67. Oh H, Edlund C. Mechanism of quinolone resistance in anaerobic bacteria. Clin Microb Infect 2004; 9: 512-517
68. Ricci V, Peterson MK, Rotschafer JC, et al. Role of topoisomerase mutation and efflux in fluoroquinolone resistance of Bacteroides fragilis clinical isolates and laboratory mutants. Antimicrob Agents Chemother 2004; 48: 1344-1346
69. Roberts MC. Acquired tetracycline and/or macrolide-lincosamides- streptogramin resistance in anaerobes. Anaerobe 2003; 9: 63-69
70. Betriu C, Culebras E, Gomez M, et al. In vitro activity of tigecycline against Bacteroides species. J Antimicrob Chemother 2005; 56: 349-352
71. Nagy E, Dowzicky MJ. In vitro activity of tigecycline and comparators against European compilation of anaerobes collected as part of the Tigecycline Evaluation and Surveillance Trial (TEST). Scand J Infect Dis 2010; 42: 33-38
72. Goldstein EJC, Citron DM, Merriam CV, et al. Comparative in vitro susceptibilities of 396 unusual anaerobic strains to tigecycline and eight other antimicrobial agents. Antimicrob Agents Chemother 2006; 50: 3507-3513
73. Yang W, Moore IF, Koteva KP, et al. TetX is a flavindependent monooxygenase conferring resistance to tetra-cycline antibiotics. J Biol Chem 2004; 279: 52346-52352
74. Betriu C, Culebras E, Gomez M, et al. Resistance trends of the Bacteroides fragilis group over a 10-year period, 1997 to 2006, in Madrid, Spain. Antimicrob Agents Chemother 2008; 52: 2686-2690
75. Koeth LM, Good CE, Appelbaum PC, et al. Surveillance of susceptibility patterns in 1297 European and US anaerobic and capnophilic isolates to co-amoxicalv and five other antimicrobial agents. J Antimicrob Chemother 2004; 53: 1039-1044
76. Handel T, Olsen I, Wolker CB, et al. Detection and char-acterization of beta-lactamase genes in subgingival bacteria from patients with refractory periodontitis. FEMS Microbiol Lett 2005; 242: 319-324
77. Arzese AR, Tomasetig L, Botta GA. Detection of tetQ and ermF antibiotic resistance genes in Prevotella and Por-phyromonas isolates from clinical specimens and resident microbiota of humans. J Antimicrob Chemother 2000; 45: 577-582
78. Scott KP, Melville CM, Barbosa TM, et al. Occurrence of the new tetracycline resistance gene tet(W) in bacteria from the human gut. Antimicrob Agents Chemother 2000; 44: 775-777
79. Nyfors S, Kononen E, Syrjanen R, et al. Emergence of penicillin resistance among Fusobacterium nucleatum populations of commensal oral flora during early childhood. J Antimicrobial Chemother 2003; 51: 107-112
80. Turner K, Lindquist L, Nord CE. Purification and properties of a novel beta-lactamase from Fusobacterium nu-cleatum. Antimicrob Agents Chemother 1985; 27: 943-947
81. Johnson CC. Susceptibility of anaerobic bacteria to beta-lactam antibiotics in the United States. Clin Infect Dis 1993; 16 Suppl.: S371-6
82. Mosca A, Miragliotta L, Iodice Ma, et al. Antimicrobial profile of Prevotella spp and Fusobacterium nucleatum isolated from periodontal infections in a selected area of southern Italy. Inter J Antimicrob Agents 2007; 30: 521-524
83. Baron EJ, Ropers G, Summanen P, et al. Bactericidal ac-tivity of selected antimicrobial agents against Bilophila wadsworthia and Bacteroides gracilis. Clin Infect Dis 1993; 16 Suppl.: S339-43
84. Molitoris E, Wexler HM, Finegold SM. Source and antimicrobial susceptibilities of Campylobacter gracilis and Sutterella wadsworthensis. Clin Infect Dis 1997; 25 Suppl.: S264-5
85. Murdoch DA. Gram-positive anaerobic cocci. Clin Microbiol Rev 1998; 11: 81-120
86. Song Y, Liu C, McTeague M, et al. 16S ribosomal DNA sequencing-based analysis of clinically significant Gram-positive anaerobic cocci. J Clin Microbiol 2003; 41: 1363-1369
87. Teng LJ, Hsuesh PR, Tsai JC, et al. High incidence of cefoxitin and clindamycin resistance among anaerobes in Taiwan. Antimicrob Agents Chemother 2002; 46: 2908-2913
88. Poulet PP, Duffaut D, Lodter JP. Metronidazole suscepti-bility testing of anaerobic bacteria associated with peri-odontal disease. J Clin Periodontol 1999; 26: 261-263
89. Theron MM, Janse Van Rensburg MN, Chalkley LJ. Nitroimidazole resistance genes (nimB) in anaerobic gram-positive cocci (previously Peptostreptococcus spp.). J Antimicrob Chemother 2004; 54: 240-242
90. Reig M, Galan J, Baquero F, et al. Macrolide resistance in Peptostreptococcus spp. mediated by ermTR: possible source of macrolide-lincosamide-streptogramin B resistance in Streptococcus pyogenes. Antimicrob Agents Chemother 2001; 45: 630-632
91. Hansen JM, Fjjeldsoe-Nielsen H, Sulim S, et al. Actino-myces species: a Danish survey on human infections and microbiological characteristics. Open Microbial J 2009; 3: 113-120
92. Oprica C, Nord EC. European surveillance study on the antibiotic susceptibility of Propionibacterium acnes. Clin Microbial Infect 2005; 11: 204-213
93. Ross JI, Snelling AM, Carnegie E, et al. Antibiotic-resistant acne: lesson from Europe. Br J Dermatol 2003; 148: 467-478
94. Brazier JS, Fawley W, Freeman J, et al. Reduced susceptibility of Clostridium difficile to metronidazole. J Antimicrobial Chemother 2001; 48: 741-742
95. Jamal WY, Mokaddas EM, Verghese TL, et al. In vitro activity of 15 antimicrobial agents against clinical isolates of Clostridium difficile in Kuwait. Int J Antimicrob Agents 2002; 20: 270-274
96. Terhes G, Urban E, Soki J, et al. Assessment of changes in the epidemiology of Clostridium difficile isolated from diarrhoeal patients in Hungary. Anaerobe 2009; 15: 237-240
97. Barbut E, Decre D, Burghoffer B, et al. Antimicrobial susceptibilities and serogroups of clinical strains of Clos-tridium difficile isolated in France in 1991 and 1997. Antimicrob Agents Chemother 1999; 43: 2607-2611
98. Bendle JS, James PA, Bennett PM, et al. Resistance de-terminants in strains of Clostridium difficile from two geographically distinct populations. Int J Antimicrob Agents 2004; 24: 619-621
99. Huang H, Weintraub A, Fang H, et al. Antibiotic resis-tance in Clostridium difficile. Inter J Antimicrob Agents 2009; 34: 516-522
100. Johansson A, Greko C, Engstrom BE, et al. Antimicrobial susceptibility of Swedish, Norwegian and Danish isolates of Clostridium perfringens from poultry and distribution of tetracycline resistance genes. Vet Microbiol 2004; 99: 251-257
101. Rafii F, Park M, Novak JS. Alteration in DNA gyrase and topoisomerase IV in resistant mutants of Clostridium perfringens found after in vitro treatment with fluoro-quinolones. Antimicrob Agents Chemother 2005; 49: 488-492
102. Spigaglia P, Barbanti F, Mastrantonio P, et al. Fluoroquinolone resistance in Clostridium difficile isolates from a prospective study of C. difficile infections in Europe. J Med Microbiol 2008; 57: 784-789
103. O'Connor JR, Galang MA, Sambol S, et al. Rifampin and rifaximin resistance in clinical isolates of Clostridium difficile. Antimicrob Agents Chemother 2008; 52: 2813-2817
104. Hecht DW, Galang MA, Sambol SP, et al. In vitro activities of 15 antimicrobial agents against 110 toxigenic Clos-tridium difficile clinical isolates collected from 1983 to 2004. Antimicrob Agents Chemother 2007; 51: 2716-2719
105. Citron DM, Babkhani F, Goldstein EJC, et al. Typing and susceptibilities of bacterial isolates from fidaxomicin (OPT-80) phase II study for C. difficile infection. Anaerobe 2009; 15: 234-236
106. Citron DM, Warren YA, Tyrrell KL, et al. Comparative in vitro activity of REP3123 against Clostridium difficile and other anaerobic intestinal bacteria. J Antimicrob Chemo-ther 2009; 63: 972-976
107. Pumbwe L, Wareham DW, Aduse-Opoku J, et al. Genetic analysis of mechanisms of multidrug resistance in a clinical isolate of Bacteroides fragilis. Clin Microbiol Infect 2007; 13: 183-189
108. Solomkin JS, Mazuski JE, Baron EJ, et al. Guidelines for the selection of anti-infective agents for complicated intra-abdominal infections. Clin Infect Dis 2003; 37: 997-1005
109. Bascones MA, Aguirre Urizar JM, Bermejo FA, et al. Consensus statement on antimicrobial treatment of odontogenic bacterial infections. Med Oral Patol Oral Cir Bucal 2004; 9: 369-376
110. Babinchak T, Ellis-Grosse E, Dartois N, et al. The efficacy and safety of tigecycline for the treatment of complicated intra-abdominal infections: analysis of pooled clinical trial data. Clin Infect Dis 2005; 41 Suppl.: S354-67
111. Fomin P, Koalov S, Cooper A, et al. The efficacy and safety of tigecycline for the treatment of complicated intra-abdominal infections: the European experience. J Chemother 2008; 20 Suppl.: S12-9
112. Ackermann G, Schaumann R, Pless B, et al. In vitro activity of telithromycin (HMR 3647) and seven other antimicrobial agents against anaerobic bacteria. J Antimicrob Chemother 2000; 45: 115-119
113. Wexler HM, Molitoris E, Molitoris D, et al. In vitro activity of telithromycin (HMR 3647) against 502 strains of anaerobic bacteria. J Antimicrob Chemother 2001; 47: 467-469
114. Snydman DR, Jacobus NV, McDermott LA. Evaluation of the in vitro activity of NVP-LMB415 against clinical anaerobic isolates with emphasis on the Bacteroides fra-gilis group. J Antimicrob Chemother 2005; 55: 1024-1028
115. Finegold SM, Bolanos M, Sumannen PH, et al. In vitro activities of televancin and six comparator agents against anaerobic bacterial isolates. Antimicrob Agents Chemo-ther 2009; 53: 3996-4001
116. Snydman DR, Jacobus NV, McDermott LA. In vitro ac-tivities of doripenem, a new broad-spectrum carbape-nems, against recently collected clinical anaerobic isolates, with emphasis on the Bacteroides fragilis group. Anti-microb Agents Chemother 2008; 52: 4492-4496
117. Tanaka K, Mikamo H, Nakao K, et al. In vitro activity of tomopenem (CS-023/RO4908463) against anaerobic bacteria. Antimicrob Agents Chemother 2009; 53: 319-322
118. Ednie LM, Appelbaum PC. Antianaerobic activity of su-lopenem compared with six other agents. Antimicrob Agents Chemother 2009; 53: 2163-2170
119. Bolton RP, Culshaw MA. Faecal metronidazole concentra-tions during oral and intravenous therapy for antibiotic associated colitis due to Clostridium difficile. Gut 1986; 27: 1169-1172
120. Huang H, Nord CE. Can metronidazole still be used for treatment of Clostridium difficile infections? Curr Infect Dis Rep 2009; 11: 3-6
121. Davidson M. Results of a phase III trial comparing tolevamer, vancomycin and metronidazole in patients with Clostridium difficile-associated diarrhoea (CDAD) [abstract no. K-425a]. 47th ICAAC; 2007 Sep 17-20; Chicago (IL)
122. Berrie C. Tolevamer less effective than standard therapies for C. difficile associated diarrhoea [abstract no. O464]. 18th ECCMID; 2008 Apr 19-22; Barcelona
123. Bartlett JG. New antimicrobial agents for patients with Clostridium difficile infections. Curr Infect Dis Rep 2009; 11: 21-28
124. Snydman DR, Jacobus NV, McDermott LA, et al. Lesson learned from the anaerobe survey: historical perspective and review of the most recent data (2005-2007). Clin Infect Dis 2010; 50 Suppl.: S26-33