Bacteremic pneumococcal pneumonia associated with macrolide failure.
Despite rising rates of macrolide resistance to Streptococcus pneumoniae, the current guidelines for outpatient treatment of community-acquired pneumonia include a macrolide as initial empiric therapy. There have only been a few previously documented cases of macrolide treatment failure in community-acquired pneumonia and there is controversy as to whether macrolide resistance in S. pneumoniae is clinically important. Reported here are two cases of community-acquired pneumonia caused by S. pneumoniae, one of which was fatal, that failed to respond to clarithromycin.
Dylewski
J
J
Department of Medicine, St. Mary's Hospital, 3830 Lacombe, Montreal, Quebec H3T 1M5, Canada. joe.dylewski@ssss.gouv.qc.ca
Davidson
R
R
D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D018942:Macrolides / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008826:Microbial Sensitivity Tests; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D017211:Treatment Failure
D000900:Anti-Bacterial Agents; D018942:Macrolides