Macrolide and ketolide resistance with Streptococcus pneumoniae.
Antimicrobial agents in the macrolide family have long been considered drugs of potential utility in the management of infections caused by Streptococcus pneumoniae. However, with the emergence of macrolide resistance, the clinical value of macrolides in pneumococcal infections is threatened. In part, as a consequence of the development of macrolide resistance, recently the first agent in the ketolide antimicrobial class, telithromycin, was developed and introduced into clinical practice. The ketolides are macrolide antimicrobials whose chemistry has been modified so as avoid the effects of the most common mechanisms of macrolide resistance with S pneumoniae. This discussion reviews the current state of resistance to macrolides and ketolides with S pneumoniae in North America.
Doern
Gary V
GV
Clinical Microbiology Laboratories, University of Iowa Hospital and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA. gary-doern@uiowa.edu
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017963:Azithromycin / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000502:physiology; D017291:Clarithromycin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D006801:Humans; D048628:Ketolides / Q000494:pharmacology*; D018942:Macrolides / Q000494:pharmacology*; D008565:Membrane Proteins / Q000502:physiology; D011008:Pneumococcal Infections / Q000188:drug therapy; D013296:Streptococcus pneumoniae / Q000187:drug effects*
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D048628:Ketolides; D018942:Macrolides; C117866:MefA protein, Streptococcus; D008565:Membrane Proteins; D017963:Azithromycin; D017291:Clarithromycin