Dissociation between inhibition and killing by levofloxacin in human granulocytic anaplasmosis.
Human granulocytic anaplasmosis (HGA) is a potentially fatal tick-borne infection caused by Anaplasma phagocytophilum. Treatment options are limited for this entity, with doxycycline being the drug of choice. Certain fluoroquinolones such as levofloxacin are active against A. phagocytophilum in vitro. We report a hospitalized patient with HGA who improved coincident with a 13-day course of levofloxacin therapy, but clinically and microbiologically relapsed 15 days after completion of treatment. Relapse of infection after levofloxacin therapy was reproduced in a severe combined immune-deficient (SCID) mouse infection model. Quinolone therapy should not be considered curative of HGA.
Wormser
Gary P
GP
Division of Infectious Diseases, Depatment of Medicine, New York Medical College, Westcheser Medical Center, Valhalla, New York, USA. Gary_Wormser@nymc.edu
Filozov
Alina
A
Telford
Sam R
SR
Utpat
Sandeepa
S
Kamer
Russell S
RS
Liveris
Dionysios
D
Wang
Guiqing
G
Zentmaier
Lois
L
Schwartz
Ira
I
Aguero-Rosenfeld
Maria E
ME
D000368:Aged; D041081:Anaplasma phagocytophilum / Q000187:drug effects* / Q000254:growth & development / Q000472:pathogenicity; D000712:Anaplasmosis / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008297:Male; D051379:Mice; D016513:Mice, SCID; D015242:Ofloxacin / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin