Third generation cephalosporins and piperacillin/tazobactam have distinct impacts on the microbiota of critically ill patients

Hasinika K. A. H. Gamage, Carola Venturini, Sasha G. Tetu, Masrura Kabir, Vineet Nayyar, Andrew N. Ginn, Belinda Roychoudhry, Lee Thomas, Mitchell Brown, Andrew Holmes, Sally R. Partridge, Ian Seppelt, Ian T. Paulsen*, Jonathan R. Iredell

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    9 Citations (Scopus)
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    Effective implementation of antibiotic stewardship, especially in critical care, is limited by a lack of direct comparative investigations on how different antibiotics impact the microbiota and antibiotic resistance rates. We investigated the impact of two commonly used antibiotics, third-generation cephalosporins (3GC) and piperacillin/tazobactam (TZP) on the endotracheal, perineal and faecal microbiota of intensive care patients in Australia. Patients exposed to either 3GC, TZP, or no β-lactams (control group) were sampled over time and 16S rRNA amplicon sequencing was performed to examine microbiota diversity and composition. While neither treatment significantly affected diversity, numerous changes to microbiota composition were associated with each treatment. The shifts in microbiota composition associated with 3GC exposure differed from those observed with TZP, consistent with previous reports in animal models. This included a significant increase in Enterobacteriaceae and Enterococcaceae abundance in endotracheal and perineal microbiota for those administered 3GC compared to the control group. Culture-based analyses did not identify any significant changes in the prevalence of specific pathogenic or antibiotic-resistant bacteria. Exposure to clinical antibiotics has previously been linked to reduced microbiota diversity and increased antimicrobial resistance, but our results indicate that these effects may not be immediately apparent after short-term real-world exposures.

    Original languageEnglish
    Article number7252
    Pages (from-to)1-10
    Number of pages10
    JournalScientific Reports
    Issue number1
    Publication statusPublished - 31 Mar 2021

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    Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


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