Abstract
Despite rising rates of macrolide resistance to Streptococcus pneumoniae, the current guidelines for outpatient treatment of community-acquired pneumonia include a macrolide as initial empiric therapy. There have only been a few previously documented cases of macrolide treatment failure in community-acquired pneumonia and there is controversy as to whether macrolide resistance in S. pneumoniae is clinically important. Reported here are two cases of community-acquired pneumonia caused by S. pneumoniae, one of which was fatal, that failed to respond to clarithromycin.
MeSH terms
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Adult
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Aged, 80 and over
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Anti-Bacterial Agents / pharmacology
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Anti-Bacterial Agents / therapeutic use*
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Bacteremia / diagnosis
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Bacteremia / drug therapy*
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Bacteremia / microbiology
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Drug Resistance, Bacterial
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Fatal Outcome
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Female
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Humans
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Macrolides / pharmacology
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Macrolides / therapeutic use*
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Male
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Microbial Sensitivity Tests
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Pneumonia, Pneumococcal / diagnosis
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Pneumonia, Pneumococcal / drug therapy*
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Pneumonia, Pneumococcal / etiology
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Streptococcus pneumoniae / drug effects*
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Streptococcus pneumoniae / isolation & purification
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Treatment Failure
Substances
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Anti-Bacterial Agents
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Macrolides