Fluoroquinolone and Macrolide Treatment Failure.

In January 2007, a 71-year-old man, who was allergic to penicillin and had a past of chronic obstructive pulmonary disease, was hospitalized due to pneumonia.
The honours S. pneumoniae form was isolated from sputum obtained before antibiotic artistic style with intravenous levofloxacin (500 mg once a day for 13 days) was begun.
On day 4, intravenous clarithromycin (500 mg twice a day) was added but withdrawn after 4 doses.
On day 14, clinical and radiologic good health had deteriorated, and idiom was changed to intravenous clarithromycin (500 mg) and intravenous ciprofloxacin (200 mg) twice a day for 7 days.
On the same day, a mo pneumococcal isolate resistant to levofloxacin and clarithromycin but susceptible to clindamycin was obtained (Table 1).
The MIC of clarithromycin for this secondment isolate was 2 µg/mL; by the double-disk test ; showed that the susceptibility of clindamycin was not modified after the erythromycin elicitation.
Initially, this tender isolate was incorrectly reported as clarithromycin susceptible because of an erroneous phonograph recording of the resultant role of the disk-diffusion playing.
On day 24, the semantic role was discharged with oral clarithromycin.
Twenty-four period of time later, the patient role was readmitted with exasperation of the respiratory health problem and cor pulmonale, and two pneumococcal isolates resistant to levofloxacin, clarithromycin, and clindamycin were found within 6 time period.
The affected role received bactrim for 5 days; a twenty percent pneumococcal isolate was found from a pleural flood illustration.
The pneumonia completely resolved after 10 days of idiom with vancomycin.
The five S. pneumoniae serotype 3 isolates recovered over a 32-day stop had the same PFGE, BOX-PCR patterns, and multilocus chronological succession typing (ST180) results.
All S. pneumoniae isolates were susceptible to penicillin (MIC trimethoprim-sulfamethoxazole (MIC
This is a part of article Fluoroquinolone and Macrolide Treatment Failure. Taken from "Bactrim Information" Information Blog