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May 1985

Cefoxitin Resistance in Community-Acquired Gram-negative Bacillary Bacteremia: Associated Clinical Risk Factors

Author Affiliations

From the Section on General Medicine and Geriatrics, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC (Dr McCue).

Arch Intern Med. 1985;145(5):834-836. doi:10.1001/archinte.1985.00360050078014

• Among 185 patients with nonneutropenic, community-acquired gram-negative bacillary bacteremias, clinical risk factors for cefoxitin resistance included (1) any antibiotic taken within the last three weeks (25.6% cefoxitin resistance), (2) long-term bladder catheterization or surgical urinary diversion (23.3%), (3) hospitalization within the last 30 days (22.9%), and (4) nursing home residence before admission (20.8%). Patients with none of these risk factors were less likely to have cefoxitin-resistant bacteremias (0.9%). When these risk factors were examined in the subgroups of urinary tract and non—urinary tract sources of community-acquired gram-negative bacillary bacteremia, they were also helpful in predicting sensitivity to trimethoprim-sulfamethoxazole and gentamicin. The presence of one or more of the risk factors identified may be a useful adjunct in determining initial empiric antimicrobial therapy for community-acquired gram-negative bacillary bacteremia.

(Arch Intern Med 1985;145:834-836)