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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Streptococcus pneumoniae bacteraemia: pharmacodynamic correlations with outcome and macrolide resistance-a controlled study
International Journal of Antimicrobial Agents, Volume 30, No. 3, Year 2007
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Description
There are few data on macrolide pharmacodynamics in pneumococcal infections. We evaluated pneumococcal area under the inhibitory concentration-time curve (AUIC) values at the point of hospital admission in 59 bacteraemic patients failing in the community and in 98 bacteraemic controls without macrolide exposure. The area under the 24-h concentration-time curve (AUC24) was calculated for each patient using age, weight and daily dose; using minimum inhibitory concentrations (MICs), the values of AUIC (i.e. AUC24/MIC) were then computed. Clinical and outcome information was also collected in hospital. Five of six patients who died of pneumococcal bacteraemia in hospital received azithromycin, with a mean AUIC of 8.1 prior to hospital admission. Resistant isolates were recovered in 35 (59%) macrolide failures and in only 28 (29%) controls (P = 0.001). Azithromycin AUICs averaged 10 in failure patients and 17 in controls. For clarithromycin and erythromycin, the mean AUIC values in failures were 31 and 53, respectively, and the AUIC in controls was >100. Low AUIC values against Streptococcus pneumoniae precede macrolide failures in the community. Patient factors do not predict these outcomes and thus the most likely explanation for macrolide failure in the community is inadequate macrolide activity in patients who receive these antibiotics for treatment of organisms that are not sufficiently susceptible. © 2007 Elsevier B.V. and the International Society of Chemotherapy.
Authors & Co-Authors
Schentag, Jerome J.
United States, Buffalo
University at Buffalo, the State University of new York
Klugman, K. P.
United States, Atlanta
Rollins School of Public Health
Yu, Victor L.
United States, Pittsburgh
University of Pittsburgh
Chiou, Christine Chia Christine
Taiwan, Taipei
National Yang-ming University Taiwan
Patel, Manish
France, Gentilly
Sanofi S.a.
Lavin, Bruce S.
France, Gentilly
Sanofi S.a.
Statistics
Citations: 25
Authors: 6
Affiliations: 5
Identifiers
Doi:
10.1016/j.ijantimicag.2007.04.013
ISSN:
09248579
Research Areas
Cancer
Health System And Policy