Failure of pristinamycin treatment in a case of pneumococcal pneumonia

  • C. Burucoa
  • T. Pasdeloup
  • C. Chapon
  • J. L. Fauchère
  • R. Robert
Notes

Abstract

A case of pneumonia caused byStreptococcus pneumoniae occurring in a patient receiving pristinamycin is reported. Despite empirical treatment with pristinamycin, 2 g/day for five days, the patient's condition worsened. Protected brush specimen and blood cultures permitted isolation ofStreptococcus pneumoniae. MIC testing indicated that the strain was susceptible to pristinamycin and resistant to erythromycin and penicillin.Streptococcus pneumoniae was eradicated by cefotaxime, and pneumonia resolved. This case underlines the fact that pristinamycin may not be suitable for the treatment of multiresistant pneumococcal infections.

References

  1. 1.
    Geslin P, Fremaux A, Sissia G: Epidémiologie de la résistance deStreptococcus pneumoniae aux bêtalactamines en France et dans le monde. In: Carbon C, Chastang C, Decazes JM (ed): Infections à pneumocoques de sensibilité diminuée aux bêta-lactamines. Springer, Paris, 1993, p. 55–71.Google Scholar
  2. 2.
    Fremaux A, Sissia G, Geslin P: Activité antibactérienne in vitro de la pristinamycine surStreptococcus pneumoniae résistant à la pénicilline. Pathologie Biologie 1993, 41: 636–640.Google Scholar
  3. 3.
    Krisher K, Linscott A: Comparison of three commercial MIC systems, E test, fastidious antimicrobial susceptibility panel, and FOX fastidious panel, for confirmation of penicillin and cephalosporin resistance inStreptococcus pneumoniae. Journal of Clinical Microbiology 1994, 32: 2242–2245.Google Scholar
  4. 4.
    Stratton CW, Cooksey C: Susceptibility tests: special tests. In: Balows A, Hausler WJ, Herrmann KL, Isenberg HD, Shadomy HJ (ed): Manual of clinical microbiology. American Society for Microbiology, Washington, DC, 1991, p. 1153–1165.Google Scholar
  5. 5.
    Emond JP, Fremaux A, Dublanchet A, Sissia G, Geslin P, Sedalian A, Lionsquy G: Resistance of two strains ofStreptococcus pneumoniae to pristinamycin associated with 16-membered macrolides. Pathologie Biologie 1989, 37: 791–792.Google Scholar
  6. 6.
    Leclerc R, Courvalin P: Bacterial resistance to macrolide, lincosamide, and streptogramin antibiotics by target modification. Antimicrobial Agents and Chemotherapy 1991, 35: 1267–1272.Google Scholar
  7. 7.
    Nguyen J: Activité in vitro antipneumococcique des streptograminés. In: Pocidalo JJ, Vachon F, Coulaud JP, Vildé JL (ed): Macrolides et synergistines. Arnette, Paris, 1988, p. 115–118.Google Scholar
  8. 8.
    Koechlin C, Kempf JF, Jehl F, Monteil H: Single oral dose pharmacokinetics of the two main components of pristinamycin in humans. Journal of Antimicrobial Chemotherapy 1990, 25: 651–656.Google Scholar

Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1995

Authors and Affiliations

  • C. Burucoa
    • 1
  • T. Pasdeloup
    • 2
  • C. Chapon
    • 2
  • J. L. Fauchère
    • 1
  • R. Robert
    • 2
  1. 1.Laboratoire de Microbiologie ACentre Hospitalier Universitaire La MilétriePoitiersFrance
  2. 2.Service de Réanimation MédicaleCentre Hospitalier Universitaire La MilétriePoitiersFrance

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