Call for the international adoption of microbiological breakpoints for fluoroquinolones and Streptococcus pneumoniae

Int J Antimicrob Agents. 2006 Sep;28(3):266-9. doi: 10.1016/j.ijantimicag.2006.04.007. Epub 2006 Aug 9.

Abstract

The use of current Clinical and Laboratory Standards Institute levofloxacin breakpoints for assessing fluoroquinolone resistance in Streptococcus pneumoniae is inadequate for detecting isolates possessing first-step parC mutations. Consequently, the risk for development of fluoroquinolone resistance is greatly underestimated. Adopting microbiological breakpoints for fluoroquinolones and S. pneumoniae, where parC mutations are rare in susceptible isolates, more accurately describes the emergence of resistance and may help to prevent a number of future fluoroquinolone treatment failures. Additionally, we propose that the use of a second fluoroquinolone marker, such as ciprofloxacin, offers the best prediction for detecting an isolate possessing a first-step parC mutation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Infective Agents / pharmacology*
  • Anti-Infective Agents / therapeutic use
  • Drug Resistance, Bacterial / genetics*
  • Fluoroquinolones / pharmacology*
  • Fluoroquinolones / therapeutic use
  • Humans
  • Levofloxacin
  • Microbial Sensitivity Tests / standards*
  • North America
  • Ofloxacin / therapeutic use
  • Pneumococcal Infections / drug therapy
  • Pneumococcal Infections / microbiology
  • Point Mutation
  • Streptococcus pneumoniae / drug effects*
  • Streptococcus pneumoniae / genetics*

Substances

  • Anti-Infective Agents
  • Fluoroquinolones
  • Levofloxacin
  • Ofloxacin