Abstract
The fatal outcome of levofloxacin treatment in a patient with bacteremic pneumonia caused by Streptococcus pneumoniae with a preexisting parC mutation is reported. Failure was due to the emergence of a gyrA mutation after 4 days of therapy. Problems encountered in detecting first-step mutation isolates are discussed.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Aged
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Anti-Bacterial Agents / therapeutic use*
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Bacteremia / drug therapy*
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Bacteremia / microbiology
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DNA Gyrase / genetics
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DNA Topoisomerase IV / genetics*
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Drug Resistance, Bacterial / genetics
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Fatal Outcome
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Humans
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Levofloxacin*
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Male
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Mutation*
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Ofloxacin / therapeutic use*
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Pneumonia, Pneumococcal / drug therapy*
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Pneumonia, Pneumococcal / microbiology
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Streptococcus pneumoniae / drug effects*
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Streptococcus pneumoniae / enzymology
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Streptococcus pneumoniae / genetics
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Treatment Failure
Substances
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Anti-Bacterial Agents
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Levofloxacin
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Ofloxacin
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DNA Topoisomerase IV
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DNA Gyrase