Clinical and public health implications of macrolide-resistant Streptococcus pneumoniae
Infectious Diseases; Pathology; united-states; Pharmacology & Pharmacy; in-vitro; Oncology; community-acquired pneumonia; macrolide resistance; streptococci; respiratory; pneumoniae; haemophilus-influenzae; moraxella-catarrhalis; tract infections; macrolides; otitis-media; group-a; erythromycin resistance; decreased susceptibility; initial antimicrobial therapy; pneumococcal resistance; S.; treatment failure
Macrolide resistance among Streptococcus pneumoniae is a growing global concern, although its specific impact on public health is not currently well defined. A Consensus Working Group was convened in March 2001 to address whether credible, scientific data substantiate macrolide resistance in S. pneumoniae as: (i) producing significant morbidity; (ii) creating attendant health and economic burdens; (iii) constituting a public health threat; and (iv) warranting intervention, including development of new antibiotics with efficacy against these strains. Despite the limitations of available clinical data, concern about the possibility of treatment failure with macrolides is being expressed in clinical practice and in formal treatment guidelines, threatening the important role of these agents in the treatment of respiratory tract infections. Further studies are required to monitor and control macrolide resistance and evaluate settings in which macrolide treatment failures are occurring, and new therapeutic interventions are needed.
Moellering R C; Consensus Working Grp
Journal of Chemotherapy
2002
2002-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1080/1120009x.2002.11782351" target="_blank" rel="noreferrer noopener">10.1080/1120009x.2002.11782351</a>
Persistently positive culture results in a patient with community-acquired pneumonia due to Legionella pneumophila
azithromycin; clarithromycin; erythromycin; hospitalized-patients; Immunology; Infectious Diseases; legionnaires-disease; macrolides; Microbiology; pcr; pharmacokinetics; time
We describe a patient with community-acquired pneumonia due to Legionella pneumophila serogroup 6. This patient was found to have bronchoalveolar carcinoma of the lung by means of cytologic testing in 1 of 2 bronchoalveolar lavage samples, but no lesions were visible on bronchoscopy. Despite intravenous administration of azithromycin to the patient, repeat culture and polymerase chain reaction showed persistence of Legionella; the isolates remained susceptible to azithromycin. The patient did not respond to 14 doses of daily intravenously administered azithromycin. The poor outcome may have been partially due to the suspected underlying lung malignancy, as shown by cytologic examination, and by a delay in seeking medical attention.
Tan J S; File T M; DiPersio J R; DiPersio L P; Hamor R; Saravolatz L D; Stout J E
Clinical Infectious Diseases
2001
2001-06
Journal Article
<a href="http://doi.org/10.1086/320526" target="_blank" rel="noreferrer noopener">10.1086/320526</a>