Susceptibilities to Levofloxacin in
 Streptococcus pneumoniae
 ,
 Haemophilus influenzae
 , and
 Moraxella catarrhalis
 Clinical Isolates from Children: Results from 2000-2001 and 2001-2002 TRUST Studies in the United States

Karlowsky, James A.; Thornsberry, Clyde; Critchley, Ian A.; Jones, Mark; Evangelista, Alan T.; Noel, Gary J.; Sahm, Daniel F.

doi:10.1128/aac.47.6.1790-1797.2003

Cited by 50 publications

(55 citation statements)

References 26 publications

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“…48 The Tracking Resistance in the United States Today (TRUST) study reported that although S. pneumoniae isolates were highly resistant to penicillin and azithromycin (15%-44% according to the age group of patients from whom the isolates were recovered), resistance to ceftriaxone and amoxicillin-clavulanate was lower (1%-10%) and was minimal for levofloxacin (0%-1.3%). 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.…”

Section: Odds Ratio (95% Ci)supporting

confidence: 74%

“…[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. 55 Administration of fluoroquinolones was associated with better treatment success among patients with severe pneumonia.…”

Section: Odds Ratio (95% Ci)mentioning

confidence: 99%

See 1 more Smart Citation

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)supporting

confidence: 74%

Section: Odds Ratio (95% Ci)mentioning

confidence: 99%

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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“…A longitudinal surveillance study, Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin (PROTEKT) study, collected pathogens from adult and pediatric patients with respiratory tract infections throughout Japan, including 1 hospital in the Tohoku district, during the period from 1999 to 2004 (Inoue et al 2008 (12.5%) in our study was higher than that found in the JSC study. The prevalence of PRSP strains isolated from pediatric infections has been reported to be higher (16.9-49.0%) than the prevalence found in adult infections (Karlowsky et al 2003;Chiba et al 2005). Therefore, the discrepancy in the incidence of PRSP between the JSC and the current study might be due to the fact that pediatric patients were included in the current study, but were excluded from the JSC study.…”

Section: Discussioncontrasting

confidence: 42%

Trends in Antimicrobial Susceptibility of Streptococcus pneumoniae in the Tohoku District of Japan: A Longitudinal Analysis from 1998 to 2007

Nishimaki

Okuyama

et al. 2010

Tohoku J. Exp. Med.

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“…To date, the highest prevalence described has been Ͻ1.3% in adults (22). Despite an increase in the prevalence of levofloxacin-resistant isolates during the surveillance period of our study (1998 to 2002), the overall proportion of levofloxacin-resistant strains has remained Ͻ1%.…”

Section: Discussionmentioning

confidence: 94%

Levofloxacin-Resistant Invasive Streptococcus pneumoniae in the United States: Evidence for Clonal Spread and the Impact of Conjugate Pneumococcal Vaccine

Pletz

McGee

Jorgensen

et al. 2004

Antimicrob Agents Chemother

104

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The emergence of fluoroquinolone resistance in sterile-site isolates of Streptococcus pneumoniae is documented in this study characterizing all invasive levofloxacin-resistant (MIC, >8 mg/liter) S. pneumoniae isolates (n ‫؍‬ 50) obtained from the Centers for Disease Control and Prevention Active Bacterial Core Surveillance from 1998 to 2002. Resistance among all isolates increased from 0.1% in 1998 to 0.6% in 2001 (P ‫؍‬ 0.008) but decreased to 0.4% in 2002, while resistance among vaccine serotypes continued to increase from 0.3% in 1998 to 1.0% in 2002, suggesting that fluoroquinolones continue to exert selective pressure on these vaccine serotypes. Only 22% of resistant isolates were not covered by the conjugate vaccine serogroups. Multilocus sequence typing revealed that 58% of resistant strains were related to five international clones identified by the Pneumococcal Molecular Epidemiology Network, with the Spain 23F -1 clone being most frequent (16% of all isolates). Thirty-six percent of the isolates were coresistant to penicillin, 44% were coresistant to macrolides, and 28% were multiresistant to penicillin, macrolides, and fluoroquinolones. Fifty percent of the isolates were resistant to any three drug classes. Ninety-four percent of the isolates had multiple mutations in the quinolone resistance-determining regions of the gyrA, gyrB, parC, and parE genes. In 16% of the isolates, there was evidence of an active efflux mechanism. An unusual isolate was found that showed only a single parE mutation and for which the ciprofloxacin MIC was lower (2 mg/liter) than that of levofloxacin (8 mg/liter). Our results suggest that invasive pneumococcal isolates resistant to levofloxacin in the United States show considerable evidence of multiple resistance and of clonal spread.

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Susceptibilities to Levofloxacin in Streptococcus pneumoniae , Haemophilus influenzae , and Moraxella catarrhalis Clinical Isolates from Children: Results from 2000-2001 and 2001-2002 TRUST Studies in the United States

Cited by 50 publications

References 26 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

Trends in Antimicrobial Susceptibility of Streptococcus pneumoniae in the Tohoku District of Japan: A Longitudinal Analysis from 1998 to 2007

Levofloxacin-Resistant Invasive Streptococcus pneumoniae in the United States: Evidence for Clonal Spread and the Impact of Conjugate Pneumococcal Vaccine

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