Related Experiment Videos
New cause of penicillin treatment failure
Abstract:
A large empyema infected with a penicillin-sensitive haemolytic group B streptococcus failed to respond to high doses of penicillin. After two weeks' treatment the pus aspirated was found not only to contain no penicillin, but also to inactivate penicillin added to it. We believe that the inactivating agent is an enzyme that may destroy various penicillins and cephalosporins but has no effect on other common antibiotics. When treatment was changed to doxycycline the patient made a rapid recovery.
Insights
A penicillin-resistant empyema infection due to group B Streptococcus was treated with penicillin, but the pus inactivated the antibiotic. Switching to doxycycline led to a rapid patient recovery.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Empyema is a serious condition involving pus in the pleural space.
- Group B Streptococcus can cause severe infections, including empyema.
- Penicillin is a standard antibiotic treatment for many bacterial infections.
Observation:
- A patient with a large empyema caused by penicillin-sensitive group B Streptococcus did not improve with high-dose penicillin therapy.
- Pus aspirated from the empyema after two weeks of penicillin treatment contained no detectable penicillin and inactivated added penicillin.
- This inactivation suggested the presence of a penicillin-degrading agent within the empyema fluid.
Findings:
- The inactivating agent appears to be an enzyme.
- This enzyme likely degrades various penicillins and cephalosporins.
- The enzyme showed no effect on other common antibiotics, such as doxycycline.
Implications:
- This case highlights a novel mechanism of penicillin resistance in empyema.
- The identification of a specific enzyme inactivating beta-lactam antibiotics is crucial for understanding treatment failures.
- Alternative antibiotics like doxycycline may be effective when such enzymatic inactivation occurs, offering a viable treatment strategy.