In vitro activity of levofloxacin against contemporary clinical isolates of Legionella pneumophila, Mycoplasma pneumoniae and Chlamydia pneumoniae from North America and Europe

Critchley, Ian A.; Jones, Mark; Heinze, Paul; Hubbard, D A; Engler, Howard D.; Evangelista, Alan T.; Thornsberry, Clyde; Karlowsky, James A.; Sahm, Daniel F.

doi:10.1046/j.1469-0691.2002.00392.x

Cited by 71 publications

(35 citation statements)

References 36 publications

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“…Macrolides exhibit excellent in vitro activity against atypical respiratory pathogens, and have traditionally been considered drugs of first choice for infections due to atypical pathogens [15][16][17][18][19][20][21][22][23]. Against contemporary isolates of C. pneumoniae, the minimum inhibitory concentration minimal inhibitory concentration of 90% bacteria values of the macrolides (erythromycin, roxithromycin, clarithromycin and azithromycin) are typically in the range of 0.016-0.5 mg?L -1 [15,21,22,24,25].…”

Section: In Vitro Susceptibilitymentioning

confidence: 99%

“…Against contemporary isolates of C. pneumoniae, the minimum inhibitory concentration minimal inhibitory concentration of 90% bacteria values of the macrolides (erythromycin, roxithromycin, clarithromycin and azithromycin) are typically in the range of 0.016-0.5 mg?L -1 [15,21,22,24,25]. Macrolides are especially potent against strains of M. pneumoniae, with recent studies showing MIC90 values of 0.0019, 0.0019 and 0.0039 mg?L -1 for erythromycin, clarithromycin and roxithromycin respectively [19], and of v0.0005 mg?L -1 for azithromycin [15]. The newer macrolides tend to exhibit greater in vitro activity against L. pneumophila than do the older agents, such as erythromycin [20].…”

Section: In Vitro Susceptibilitymentioning

confidence: 99%

“…However, their in vitro potency is often inferior to that of the macrolides and fluoroquinolones [15,16,19,23]. Furthermore, there is evidence to suggest that strains of M. pneumoniae are developing resistance to tetracycline [23].…”

Section: In Vitro Susceptibilitymentioning

confidence: 99%

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Atypical pathogens and respiratory tract infections

Blasi¹

2004

European Respiratory Journal

109

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The atypical respiratory pathogens Chlamydia pneumoniae, Mycoplasma pneumoniae and Legionella pneumophila are now recognised as a significant cause of acute respiratory-tract infections, implicated in community-acquired pneumonia, acute exacerbations of chronic bronchitis, asthma, and less frequently, upper respiratory-tract infections.Chronic infection with C. pneumoniae is common among patients with chronic obstructive pulmonary disease and may also play a role in the natural history of asthma, including exacerbations. The lack of a gold standard for diagnosis of these pathogens still handicaps the current understanding of their true prevalence and role in the pathogenesis of acute and chronic respiratory infections.While molecular diagnostic techniques, such as polymerase chain reaction, offer improvements in sensitivity, specificity and rapidity over culture and serology, the need remains for a consistent and reproducible diagnostic technique, available to all microbiology laboratories.Current treatment guidelines for community-acquired pneumonia recognise the importance of atypical respiratory pathogens in its aetiology, for which macrolides are considered suitable first-line agents. The value of atypical coverage in antibiotic therapy for acute exacerbations of chronic bronchitis and exacerbations of asthma is less clear, while there is no evidence to suggest that atypical pathogens should be covered in antibiotic treatment of upper respiratory-tract infections. The term "atypical pathogen" most commonly refers to Chlamydia pneumoniae, Mycoplasma pneumoniae and Legionella pneumophila. Once believed to be of little clinical significance, a wealth of data accumulated over the past decade suggests that these are important respiratory pathogens in a wide range of respiratory-tract infections (RTIs) and are capable of causing severe, as well as mild-to-moderate, illness.Although the role of atypical pathogens [1], and of C. pneumoniae in particular [2], has been reviewed previously, there has been little focus on appropriate coverage of these pathogens in treatment decisions for patients with RTIs. In addressing this issue, this review examines the role of atypical pathogens in the aetiology of upper and lower RTIs, in both adults and children, and discusses the value of appropriate coverage of these pathogens in empirical antibiotic prescribing.

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Section: In Vitro Susceptibilitymentioning

confidence: 99%

Section: In Vitro Susceptibilitymentioning

confidence: 99%

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Atypical pathogens and respiratory tract infections

Blasi¹

2004

European Respiratory Journal

109

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“…Susceptibility rates for the relevant pathogens for the USA and Canada were taken from various data sources [44,45,[47][48][49][50][51][52][53] and data from two current global CAP studies [54,55] were integrated to create aggregated etiology patterns. The relevant pathogens included S. pneumoniae, H. influenzae, M. pneumoniae, C. pneumoniae (previous Chlamydia pneumoniae) Legionella pneumoniae, Klebsiella pneumoniae, and methicillin-susceptible Staphylococcus aureus.…”

Section: Methodsmentioning

confidence: 99%

Application of the Formula for Rational Antimicrobial Therapy (FRAT) to Community-Acquired Pneumonia

Blondeau¹,

Theriault²

2017

J Infect Dis Ther

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Community-acquired pneumonia (CAP) remains a common condition for which patients seek medical advice in the outpatient setting and where antimicrobial agents are prescribed empirically-often based on therapeutic guideline recommendations. Antimicrobial resistance impacts on therapeutic choices as resistance is associated with clinical failure which in turn may impact morbidity and mortality. The Formal for Rational Antimicrobial Therapy (FRAT) considers etiology and antimicrobial susceptibility to generate a factor to predict the likely activity of an antimicrobial agent in CAP or any other infection for which etiology and susceptibility data can be considered. In considering the FRAT formula in CAP, amoxicillin and macrolides offer a predictability of 52.6-78.3% whereas for trimethoprim/sulfamethoxazole the predictability was 45.2% as compared to 90.1% for tetracyclines/doxycycline and 98.2% for levofloxacin (and moxifloxacin). The FRAT formula clearly differentiates antimicrobial agents based on spectrum of activity and impact of antimicrobial resistance and provides yet another factor for consideration in the selection of an antimicrobial agent for treatment of CAP.

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“…Wykazano, że MIC 90 dla Legionella pneumophila wynosi <0,003 mg/l, dla Mycoplasma pneumoniae 0,25-0,5 mg/l, a dla Chlamydophila pneumoniae -0,25-0,5 mg/l [45,46].…”

Section: Spektrum Działania Przeciwbakteryjnegounclassified

Lewofloksacyna i moksyfloksacyna w leczeniu zakażeń bakteryjnych

Płusa¹

2016

Forum Zakażeń

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STRESZCZENIE: Klasyfikacja fluorochinolonów została oparta na spektrum mikrobiologicznym i cechach farmakokinetycznych kolejno wprowadzanych preparatów, które charakteryzowały się lepszymi właściwościami farmakodynamicznymi, w tym znaczną penetracją do wnę-trza makrofagów i miejsca toczącego się procesu zapalnego. Przeprowadzona porównaw-cza analiza lewofloksacyny i moksyfloksacyny wskazuje na ich skuteczność kliniczną w kontrolowaniu zakażeń układowych zarówno w obrębie układu oddechowego, jak i moczowego, zwłaszcza w przypadku lewofloksacyny. Z tego powodu obydwa preparaty znalazły się w obowiązujących obecnie rekomendacjach postępowania w zakażeniach. Narastająca oporność na antybiotyki zmusza do ich racjonalnego stosowania -zgodnego ze światowymi wytycznymi.SŁOWA KLUCZOWE: lewofloksacyna, moksyfloksacyna, zakażenie ABSTRACT: Classification of fluoroquinolones is based on the spectrum of microbiological and pharmacokinetic characteristics in turn introduced preparations, which were characterized by improved pharmacodynamic properties, including significant penetration into the macrophages and inflammatory tissue. Conducted a comparative analysis of levofloxacin and moxifloxacin indicates clinically effective in controlling systemic infections both within the respiratory tract and urinary tract, particularly levofloxacin. For this reason, two products had been included in the recommendations of conduct infections developed in recent years. Increasing antibiotic resistance forces to their rational use -in accordance with international guidelines. WSTĘP Wskazaniem do stosowania antybiotyków są stany zapalne wywołane przez drobnoustroje. W zależności od rodzaju patogenu, jego aktywności i wrażliwości na podawany preparat o działaniu hamującym rozwój lub zabijającym bakterie, uzyskuje się odpowiedni efekt kliniczny. Najważniej-szym elementem tego postępowania, poza charakterystyką patogenu, są cechy farmakokinetyczne stosowanego antybiotyku, w tym: jego spektrum działania, stopień penetracji do miejsca toczącego się procesu zapalnego, wykazywane interakcje z innymi cząsteczkami oraz bezpieczeństwo dla chorego [1]. Posiadana wiedza w tym zakresie jest bardzo pomocna przy podejmowaniu decyzji terapeutycznych. KLASYFIKACJA FLUOROCHINOLONÓWChinolony należą do czynników przeciwbakteryjnych zsyntetyzowanych w latach 60. XX wieku w wyniku modyfikacji podstawowej dwupierścieniowej chemicznej struktury. Współczesna klasyfikacja fluorochinolonów jest oparta na spektrum mikrobiologicznym i cechach farmakokinetycznych poszczególnych preparatów. Należy podkreślić, Artyku jest dost pny na zasadzie dozwolonego u ytku osobistego. Dalsze rozpowszechnianie (w tym umieszczanie w sieci) jest zabronione i stanowi powa ne naruszenie przepisów prawa autorskiego oraz grozi sankcjami prawnymi.

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In vitro activity of levofloxacin against contemporary clinical isolates of Legionella pneumophila, Mycoplasma pneumoniae and Chlamydia pneumoniae from North America and Europe

Abstract: Levofloxacin had comparable activity to the other agents tested against the atypical respiratory pathogens, confirming its potential as an alternative for empirical therapy of community-acquired pneumonia.

Cited by 71 publications

References 36 publications

Atypical pathogens and respiratory tract infections

Atypical pathogens and respiratory tract infections

Application of the Formula for Rational Antimicrobial Therapy (FRAT) to Community-Acquired Pneumonia

Lewofloksacyna i moksyfloksacyna w leczeniu zakażeń bakteryjnych

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