Induction of beta-lactamases: in vitro phenomena and clinical relevance

An in vitro model was used to stimulate the plasma concentration-time curves for cefotaxime and cefoxitin as they would appear during treatment of patients with infections due to Enterobacter cloacae and Proteus vulgaris. The data showed that the induction of the chromosomally mediated beta-lactamase took place in both bacteria but that it had little or no effect on the bacterial kill. It is concluded that treatment failures in these settings were due to the selection of resistant mutants.