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A review of clinical failures associated with macrolide-resistant Streptococcus pneumoniae

Marek Rzeszutek1, Aleksandra Wierzbowski, Daryl J Hoban

  • 1Department of Medical Microbiology, Faculty of Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, Man. R3A 1R9, Canada.

International Journal of Antimicrobial Agents
|August 4, 2004
PubMed

Insights

Macrolide treatment failures in Streptococcus pneumoniae infections, particularly community-acquired pneumonia, are linked to macrolide resistance. Most patients received oral macrolides outpatient and survived after switching to parenteral antibiotics.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Pharmacology

Background:

  • Emerging clinical failures with macrolide antibiotics have been reported.
  • These failures are often associated with macrolide-resistant Streptococcus pneumoniae.
  • This highlights a growing concern in treating bacterial infections.

Purpose of the Study:

  • To review and analyze documented cases of macrolide treatment failure in pneumococcal infections.
  • To identify patterns and characteristics associated with these treatment failures.
  • To understand the clinical outcomes following macrolide failure.

Main Methods:

  • A literature review was conducted on cases reporting macrolide treatment failure.
  • Thirty-three cases of macrolide treatment failure in pneumococcal infections were analyzed.
  • Data on diagnosis, patient history, treatment, and outcomes were extracted.

Main Results:

  • Community-acquired pneumonia (CAP) was the most common diagnosis (88.8%).
  • Macrolide resistance, specifically the MLS(B) phenotype (63.2%), was prevalent.
  • Most patients (93.9%) received oral macrolides outpatient; 78.8% required parenteral antibiotics upon failure, with most surviving (87.8%).

Conclusions:

  • Macrolide treatment failure in Streptococcus pneumoniae infections is a significant clinical issue, often linked to resistance.
  • Community-acquired pneumonia is frequently implicated.
  • Alternative antibiotic strategies, such as parenteral therapy, are crucial for successful outcomes in treatment failures.

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