ASP
  • COVID
    • INPATIENT >
      • CONSIDERATIONS & LABS
      • PAXLOVID
      • REMDESIVIR
      • OLUMIANT
      • ACTEMRA
      • STEROIDS
      • VTE
    • OUTPATIENT
  • Education
    • Bugs & Tips
    • Agents & Spectra
  • Guidelines
    • By Infection Type
    • Surgical Prophylaxis >
      • By Procedure
      • Dosing Guide
  • Formulary
  • Antibiogram
    • 2023 Inpatient
    • 2023 Outpatient
    • 2022 Inpatient
    • 2022 Outpatient
    • 2021 Inpatient
    • 2021 Outpatient
    • 2020 Inpatient
    • 2019 Inpatient
    • 2019 Outpatient
  • About
    • ASP Program
    • Stats & Data >
      • Recommendations
      • Pharmacy Data
      • MDR ORGANISMS
      • DDD/DOT
    • Contact

BACTEROIDES

GENERAL BACKGROUND​
  • Anaerobes encompass a collection of G(+) and G(-) organisms that require a reduced oxygen environment for growth
  • Anaerobes that cause infection in humans can survive in environments with more oxygen but cannot replicate in such conditions
  • Some produce spores, while others do not; some have factors that increase their virulence compared to other anaerobes
  • More than 100 species of anaerobes comprise normal human flora and are found in a number of areas, including skin, nose, mouth, throat, intestines, and vagina
  • Infections are due to breakdown of relationship with the host and are often polymicrobial
  • About 5% of all bacteremias are due to anaerobes
    • Bacteroides is #1 cause, Clostridium #2 cause (perfringens and septicum species, not difficile)
    • Source is abdominal in 50-70% of cases, female genital tract 5-20% of cases, and soft tissue 5-20% of cases
  • ​Resistance is increasing to clindamycin, cefotetan, cefoxitin, cefotaxime, penicillin, and fluoroquinolones
  • Resistance to carbapenems and beta lactamase/beta lactamase inhibitor combinations remains low

LABORATORY
  • ​Gram (-), non-spore forming
  • B. fragilis most common species, also most common anaerobe found in intra-abdominal infections
​
​TREATMENT OPTIONS
  • Susceptibilities within the Bacteroides group vary by species
    • ​B. fragilis is most susceptible, B. thetaiotaomicron most resistant
  • Most are resistant to penicillin, ampicillin, and increasingly resistant to cephalosporins (cefoxitin, cefotetan, and cefmetazole resistance increasing)
  • Over 90% are susceptible to beta lactam/beta lactamase inhibitors (amox/clav, ampicillin/sulbactam, piperacillin/tazobactam) and carbapenems
  • Clindamycin resistance varies by area but is considered significant
  • Moxifloxacin resistance is variable, or may develop during treatment in susceptible strains
  • COVID
    • INPATIENT >
      • CONSIDERATIONS & LABS
      • PAXLOVID
      • REMDESIVIR
      • OLUMIANT
      • ACTEMRA
      • STEROIDS
      • VTE
    • OUTPATIENT
  • Education
    • Bugs & Tips
    • Agents & Spectra
  • Guidelines
    • By Infection Type
    • Surgical Prophylaxis >
      • By Procedure
      • Dosing Guide
  • Formulary
  • Antibiogram
    • 2023 Inpatient
    • 2023 Outpatient
    • 2022 Inpatient
    • 2022 Outpatient
    • 2021 Inpatient
    • 2021 Outpatient
    • 2020 Inpatient
    • 2019 Inpatient
    • 2019 Outpatient
  • About
    • ASP Program
    • Stats & Data >
      • Recommendations
      • Pharmacy Data
      • MDR ORGANISMS
      • DDD/DOT
    • Contact