Antimicrobial susceptibility of community-acquired respiratory tract pathogens in the UK during 2002/3 determined locally and centrally by BSAC methods

Morrissey, Ian; Robbins, M J; Viljoen, Louise; Brown, Derek F. J.

doi:10.1093/jac/dkh540

Cited by 24 publications

(12 citation statements)

References 15 publications

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“…49,50 Other studies have reported similar findings. [51][52][53][54] In contrast, resistance among H. influenzae and Morraxella catarrhalis isolates was high for ampicillin (19%-98%) but minimal (0%-0.2%) for all other antibiotics. 49,50 However, resistance to fluoroquinolones may increase in the future, and this may have an impact on treatment outcomes.…”

Section: Odds Ratio (95% Ci)mentioning

confidence: 94%

Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials

Vardakas¹,

Siempos²,

Grammatikos³

et al. 2008

Canadian Medical Association Journal

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CMAJ ResearchBackground: We investigated whether the use of respiratory fluoroquinolones was associated with better clinical outcomes compared with the use of macrolides and β-lactams among adults with pneumonia. Methods:We searched PubMed, Current Contents, Scopus, EMBASE, ClinicalTrials.gov and Cochrane with no language restrictions. Two reviewers independently extracted data from published trials that compared fluoroquinolones (levofloxacin, moxifloxacin, gemifloxacin) with macrolides or β-lactams or both. A meta-analysis was performed with the clinical outcomes of mortality, treatment success and adverse outcomes. Results:We included 23 trials in our meta-analysis. There was no difference in mortality among patients who received fluoroquinolones or the comparator antibiotics (OR 0.85, 95% CI 0.65-1.12). Pneumonia resolved in more patients who received fluoroquinolones compared with the comparator antibiotics for the included outcomes in the intention-to-treat population (OR 1.17, 95% CI 1.00-1.36), clinically evaluable population (OR 1.26, 95% CI 1.06-1.50) and the microbiologically assessed population (OR 1.67, 95% CI 1.28-2.20). Fluoroquinolones were more effective than a combination of β-lactam and macrolide (OR 1.39, 95% CI 1.02-1.90). They were also more effective for patients with severe pneumonia (OR 1.84, 95% CI 1.02-3.29), those who required admission to hospital (OR = 1.30, 95% CI 1.04-1.61) and those who required intravenous therapy (OR = 1.44, 15% CI 1.13-1.85). Fluoroquinolones were more effective than β-lactam and macrolide in open-label trials (OR = 1.35, 95% CI 1.08-1.69) but not in blinded randomized controlled trials (OR = 1.13, 95% CI 0.85-1.50).Interpretation: Fluoroquinolones were associated with higher success of treatment for severe forms of pneumonia; however, a benefit in mortality was not evident. A randomized controlled trial that includes patients with severe pneumonia with or without bacteremia is needed.

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Section: Odds Ratio (95% Ci)mentioning

confidence: 94%

Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials

Vardakas¹,

Siempos²,

Grammatikos³

et al. 2008

Canadian Medical Association Journal

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“…11,12 Some studies have shown significantly decreased susceptibility to trimethoprim/ sulfamethoxazole (TMP/SMZ), tetracycline and chloramphenicol, but the majority showed that H. influenzae isolates were still susceptible to macrolides and ciprofloxacin. 13 In a UK study, however, macrolides showed poor activity against H. influenzae (0.86 -1.38% susceptible by disc or MIC methods) 7 and, in Taiwan, 34% of H. influenzae isolates were not susceptible to clarithromycin. 9 Data from China are less numerous.…”

Section: Resistance Of H Influenzae Isolates In Chinese Childrenmentioning

confidence: 99%

Resistance of Haemophilus influenzae Isolates in Children Under 5 Years Old with Acute Respiratory Infections in China between 2000 and 2002

Shen

Deng

et al. 2007

J Int Med Res

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“…Increasing antibiotic resistance in S. pneumoniae, H. influenzae, M. catarrhalis in particular [4][5][6][7] but in S. aureus and K. pneumoniae [8][9][10][11], too, has led to concerns about the efficacy of beta-lactam antibiotics and macrolides which are most frequently used for first-line therapy of RTIs. Therefore, fluoroquinolones (FQs) like moxifloxacin or levofloxacin offer a therapeutic alternative.…”

Section: Introductionmentioning

confidence: 99%

Pharmacodynamics of Moxifloxacin and Levofloxacin Simulating Human Serum and Lung Concentrations*

et al. 2005

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Fluoroquinolones are known to penetrate well into the infectious foci such as lung mucosa, epithelial lining fluid and alveolar macrophages achieving higher target site concentrations than the corresponding serum levels. In order to integrate the in vitro antibacterial activity and pharmacokinetics of moxifloxacin and levofloxacin, their bactericidal efficacy was assessed by simulating human serum and lung tissue concentrations using Streptococcus pneumoniae, Staphylococcus aureus and Klebsiella pneumoniae as indicator organisms. The bacteria were exposed to fluctuating moxifloxacin and levofloxacin concentrations simulating the drug levels in serum, lung mucosa, epithelial lining fluid and alveolar macrophages. The following parameters were deduced from the kill curves: area under the bactericidal kill curve normalized to the initial inoculum (AUBKC norm), the time needed to reduce the inoculum by 3 log(10) titers, and the initial bactericidal activity. In general, all these three parameters were for all the bacterial isolates having been exposed to moxifloxacin concentration dependent. In contrast, beyond a levofloxacin concentration of optimal bactericidal effect, higher drug concentrations did not further augment the bactericidal activity of levofloxacin. These data demonstrate that not all fluoroquinolones share the same pharmacodynamic targets needed to maximize their antibacterial effect.

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Antimicrobial susceptibility of community-acquired respiratory tract pathogens in the UK during 2002/3 determined locally and centrally by BSAC methods

Cited by 24 publications

References 15 publications

Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials

Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials

Resistance of Haemophilus influenzae Isolates in Children Under 5 Years Old with Acute Respiratory Infections in China between 2000 and 2002

Pharmacodynamics of Moxifloxacin and Levofloxacin Simulating Human Serum and Lung Concentrations*

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