Fluoroquinolone Resistance in <i>Streptococcus pneumoniae</i>
Authors: Matthew J. Kuehnert, Frederick S. Nolte, Carl A. Perlino
Journal: Annals of Internal Medicine (1999)

Letters17 August 1999Fluoroquinolone Resistance in Streptococcus pneumoniaeMatthew J. Kuehnert, MD, Frederick S. Nolte, PhD, and Carl A. Perlino, MDMatthew J. Kuehnert, MDEmory University School of Medicine; Atlanta, GA 30306 (Kuehnert)Emory University School of Medicine; Atlanta, GA 30306 (Nolte)Emory University School of Medicine; Atlanta, GA 30306 (Perlino)Search for more papers by this author, Frederick S. Nolte, PhDEmory University School of Medicine; Atlanta, GA 30306 (Kuehnert)Emory University School of Medicine; Atlanta, GA 30306 (Nolte)Emory University School of Medicine; Atlanta, GA 30306 (Perlino)Search for more papers by this author, and Carl A. Perlino, MDEmory University School of Medicine; Atlanta, GA 30306 (Kuehnert)Emory University School of Medicine; Atlanta, GA 30306 (Nolte)Emory University School of Medicine; Atlanta, GA 30306 (Perlino)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-4-199908170-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Hooper carefully details the “opportunities and challenges” associated with the expanding use of fluoroquinolones (1). However, although he warns that indiscriminate use of these antimicrobial agents, particularly for the treatment of respiratory infections, may lead to the emergence of resistance in Streptococcus pneumoniae, he speculates that such an event may be slow to occur. We report a clinical isolate of S. pneumoniae resistant to both levofloxacin and trovafloxacin, two newer-generation fluoroquinolones recommended for treatment of community-acquired pneumonia (2).A 63-year-old man was hospitalized with pneumonia and was empirically treated with levofloxacin, an antimicrobial agent he had ...References1. Hooper DC. Expanding uses of fluoroquinolones: opportunities and challenges [Editorial]. Ann Intern Med. 1998;129:908-10. LinkGoogle Scholar2. Bartlett JG, Breiman RF, Mandell LA, File TM. Community-acquired pneumonia in adults: guidelines for management. The Infectious Diseases Society of America. Clin Infect Dis. 1998;26:811-38. CrossrefMedlineGoogle Scholar3. Jacobs MR, Bajaksouzian S, Applebaum PC, Bolmstrom A. Evaluation of the Etest for susceptibility testing of pneumococci. Diagn Microbiol Infect Dis. 1992;15:473-8. CrossrefMedlineGoogle Scholar4. Goldsmith CE, Moore JE, Murphy PG, Ambler JE. Increased incidence of ciprofloxacin resistance in penicillin-resistant pneumococci in Northern Ireland. J Antimicrob Chemother. 1998;41:420-1. CrossrefMedlineGoogle Scholar5. Fuchs PC, Barry AL, Brown SD. Susceptibility of multi-resistant Streptococcus pneumoniae to ciprofloxacin, ofloxacin, and levofloxacin. J Antimicrob Chemother. 1997;39:671-2. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Emory University School of Medicine; Atlanta, GA 30306 (Kuehnert)Emory University School of Medicine; Atlanta, GA 30306 (Nolte)Emory University School of Medicine; Atlanta, GA 30306 (Perlino) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByQuinolone Resistance and Its Clinical RelevanceAntibiothérapie des pneumonies aiguës communautaires à Streptococcus pneumoniae : impact clinique de la résistance bactériennePenicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?Drug-resistant pneumococcal pneumonia: clinical relevance and approach to managementLiens entre résistance et échec dans les infections respiratoires communautairesA Review of Streptococcus pneumoniae Infection Treatment Failures Associated with Fluoroquinolone ResistanceFracaso terapéutico de levofloxacino en dos casos de neumonía adquirida en la comunidad complicada con empiema causados por Streptococcus pneumoniae resistente a fluoroquinolonasAn approach to the diagnosis and management of acute bacterial rhinosinusitisRole of beta-lactam agents in the treatment of community-acquired pneumoniaGuide to Selection of Fluoroquinolones in Patients with Lower Respiratory Tract InfectionsCommunity-acquired pneumonia: new management strategies for evolving pathogens and antimicrobial susceptibilitiesStreptococcus pneumoniae and community-acquired pneumonia: A cause for concernQuinolone Resistance among Pneumococci: Therapeutic and Diagnostic ImplicationsClinical relevance of antimicrobial resistance in the management of pneumococcal community-acquired pneumoniaManagement of Community-Acquired Pneumonia Caused by Drug-Resistant Streptococcus pneumoniaeAntimicrobial Treatment Guidelines for Acute Bacterial RhinosinusitisThe epidemiology of antibiotic resistance in Streptococcus pneumoniae and the clinical relevance of resistance to cephalosporins, macrolides and quinolonesEmergence of Levofloxacin-Resistant Pneumococci in Immunocompromised Adults after Therapy for Community-Acquired PneumoniaWhy do we need to eradicate pathogens in respiratory tract infections?Dead Bugs Don’t Mutate: Susceptibility Issues in the Emergence of Bacterial ResistanceMaintaining Fluoroquinolone Class Efficacy: Review of Influencing FactorsWhat have we learned about antimicrobial prescribing?Treatment of drug-resistant pneumococcal pneumoniaThe era of antimicrobial resistance—implications for the clinical laboratoryClinical isolates of Streptococcus pneumoniae resistant to levofloxacin contain mutations in both gyrA and parC genesEvaluation of the Winthrop-University Hospital Criteria to Identify Legionella PneumoniaCLINICAL USE OF THE FLUOROQUINOLONESBreakthrough Pneumococcal Bacteremia in Patients Being Treated with Azithromycin and ClarithromycinTrends and significance of antimicrobial resistance in respiratory pathogens 17 August 1999Volume 131, Issue 4Page: 312-313KeywordsAntimicrobial resistanceAntimicrobialsMinimum inhibitory concentrationPatientsPenicillinPneumoniaRespiratory system proceduresSputumStreptococcusUpper respiratory tract infections Issue Published: 17 August 1999 CopyrightCopyright © 1999 by American College of Physicians. 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