PMID- 15131461
OWN - NLM
STAT- MEDLINE
DCOM- 20040701
LR  - 20190818
IS  - 0891-3668 (Print)
IS  - 0891-3668 (Linking)
VI  - 23
IP  - 5
DP  - 2004 May
TI  - Azithromycin compared with beta-lactam antibiotic treatment failures in 
      pneumococcal infections of children.
PG  - 399-405
AB  - OBJECTIVE: To determine whether treatment failures occurred more commonly with 
      azithromycin than with beta-lactam antibiotics in children who developed invasive 
      pneumococcal disease within 30 days of receiving prior antimicrobial therapy. 
      METHODS: Retrospective review of medical records of children evaluated at Texas 
      Children's Hospital between 1996 and 2002 who had received antimicrobials 
      (azithromycin or a beta-lactam antibiotic) and developed invasive pneumococcal 
      disease within 30 days. Treatment failure was defined as invasive pneumococcal 
      infection that occurred while taking antimicrobials or within 3 days of stopping 
      azithromycin treatment or 1 day of stopping beta-lactam treatment. Penicillin and 
      azithromycin susceptibilities were determined and categorized according to 
      National Committee for Clinical Laboratory Standards guidelines. RESULTS: We 
      identified 21 and 33 children with similar demographic features who had developed 
      invasive pneumococcal disease within 1 month of receiving azithromycin or a 
      beta-lactam antibiotic, respectively. Eleven (52%) children in the azithromycin 
      group and 11 (33%) in the beta-lactam group met the definition for treatment 
      failures (P = 0.34). Eight treatment failures while receiving azithromycin were 
      caused by pneumococci with the macrolide-resistant (M) phenotype, 2 with the 
      macrolide-, lincosamide- and streptogramin B-resistant (MLSB) phenotype and 1 by 
      a macrolide-susceptible organism. In the beta-lactam group 7 had a 
      penicillin-resistant isolate, 3 had an intermediately susceptible isolate and 1 
      had a susceptible isolate. CONCLUSIONS: Our study suggests that treatment 
      failures among patients who developed invasive disease within 30 days of 
      receiving an antimicrobial occur as frequently in patients who receive 
      beta-lactam antibiotics as in those who receive azithromycin. Furthermore 
      macrolide resistant organisms are not more likely to be recovered after a 
      macrolide treatment failure than a penicillin-nonsusceptible isolate being 
      recovered after a beta-lactam treatment failure (P = 1.0).
FAU - Gonzalez, Blanca E
AU  - Gonzalez BE
AD  - Section of Infectious Diseases, Department of Pediatrics, Baylor College of 
      Medicine, Houston, TX, USA.
FAU - Martinez-Aguilar, Gerardo
AU  - Martinez-Aguilar G
FAU - Mason, Edward O Jr
AU  - Mason EO Jr
FAU - Kaplan, Sheldon L
AU  - Kaplan SL
LA  - eng
GR  - D43 TW01036/TW/FIC NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Review
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Penicillins)
RN  - 0 (beta-Lactams)
RN  - 83905-01-5 (Azithromycin)
SB  - IM
CIN - Pediatr Infect Dis J. 2004 Oct;23(10):980-1; author reply 981. PMID: 15602214
MH  - Anti-Bacterial Agents/pharmacology/*therapeutic use
MH  - Azithromycin/pharmacology/*therapeutic use
MH  - Child, Preschool
MH  - Drug Resistance, Bacterial
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Microbial Sensitivity Tests
MH  - Penicillins/pharmacology/*therapeutic use
MH  - Pneumococcal Infections/*drug therapy
MH  - Prospective Studies
MH  - Streptococcus pneumoniae
MH  - Treatment Failure
MH  - beta-Lactams/pharmacology/*therapeutic use
RF  - 18
EDAT- 2004/05/08 05:00
MHDA- 2004/07/02 05:00
CRDT- 2004/05/08 05:00
PHST- 2004/05/08 05:00 [pubmed]
PHST- 2004/07/02 05:00 [medline]
PHST- 2004/05/08 05:00 [entrez]
AID - 00006454-200405000-00004 [pii]
AID - 10.1097/01.inf.0000122605.34902.49 [doi]
PST - ppublish
SO  - Pediatr Infect Dis J. 2004 May;23(5):399-405. doi: 
      10.1097/01.inf.0000122605.34902.49.