Macrolide-Resistant Streptococcus pneumoniae in Community-Acquired Pneumonia: Clinical and Microbiological Outcomes for Patients Treated with Levofloxacin
Abstract
The rapid emergence and increasing prevalence of antimicrobial resistance in Streptococcus pneumoniae have greatly complicated the choice of empirical treatment forcommunity-acquired pneumonia (CAP). The newer macrolides, azithromycin and clarithromycin, have been popular choices for empirical therapy because of their activity against the common pathogens responsible for CAP and their improved tolerability, compared with that of erythromycin. Unfortunately, rates of resistance of S. pneumoniae to the macrolide class of antimicrobials have increased steadily during the past decade and have reached 40% in certain areas of the United States. Although the clinical relevance of macrolide-resistant strains of S. pneumoniae has been questioned, break through bacteremias and clinical failures have been reported among patients receiving macrolide therapy. Were viewed the levofloxacin clinical database to determine the clinical and microbiological outcomes for patients with CAP infected with macrolide-resistant S. pneumoniae. Levofloxacin, including the 750-mg short-course regimen currently under investigation, produced a successful clinical response in 96.9% of patients with CAP due to macrolide-resistant S. pneumoniae, compared with 95.1% of all patients.
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