In vitro development of resistance to three quinolones in Streptococcus pneumoniae

¹Sección de Microbiología, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, España. jcrd@retemail.es

|December 23, 2000

Abstract:

We studied the in vitro development of resistance to ciprofloxacin, trovafloxacin and moxifloxacin in 5 strains of Streptococcus pneumoniae resistant to penicillin. We detected the great ease of in vitro development of resistance in the case of ciprofloxacin and the much reduced capacity of moxifloxacin to generate resistance (only 1 strain). Trovafloxacin generated resistance, but more slowly than ciprofloxacin. We consider that study of the capacity to generate resistance should be one of the points to consider when deciding on their large-scale use in respiratory infections, but comparative studies between in vitro and in vivo models should be carried out so as to determine the clinical repercussion of these phenomena.

Insights

Ciprofloxacin and trovafloxacin readily developed resistance in Streptococcus pneumoniae strains in vitro. Moxifloxacin showed a significantly reduced capacity to generate resistance, suggesting careful consideration for widespread use in respiratory infections.

Area of Science:

Microbiology
Pharmacology
Infectious Diseases

Background:

Penicillin-resistant Streptococcus pneumoniae poses a significant public health challenge.
Fluoroquinolones are crucial in treating bacterial infections, including those caused by resistant strains.
Understanding resistance development is vital for effective antibiotic stewardship.

Purpose of the Study:

To investigate the in vitro development of resistance to ciprofloxacin, trovafloxacin, and moxifloxacin in penicillin-resistant Streptococcus pneumoniae.
To compare the propensity of these fluoroquinolones to induce resistance in vitro.
To inform clinical decisions regarding the large-scale use of these antibiotics in respiratory infections.

Main Methods:

In vitro susceptibility testing of five penicillin-resistant Streptococcus pneumoniae strains.
Exposure of bacterial strains to sub-inhibitory concentrations of ciprofloxacin, trovafloxacin, and moxifloxacin.
Monitoring the emergence and development of resistance over time.

Main Results:

Ciprofloxacin demonstrated a high propensity for in vitro resistance development in Streptococcus pneumoniae.
Trovafloxacin also induced resistance, but at a slower rate compared to ciprofloxacin.
Moxifloxacin exhibited a markedly reduced capacity to generate resistance, with only one strain developing resistance.

Conclusions:

The ease of in vitro resistance development varies significantly among fluoroquinolones against Streptococcus pneumoniae.
Moxifloxacin appears to have a lower potential for inducing resistance compared to ciprofloxacin and trovafloxacin.
Further in vivo studies are necessary to correlate in vitro resistance findings with clinical outcomes in respiratory infections.

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