Fluoroquinolone and macrolide treatment failure in pneumococcal pneumonia and selection of multidrug-resistant isolates

Emerg Infect Dis. 2003 Sep;9(9):1159-62. doi: 10.3201/eid0909.020810.


Streptococcus pneumoniae serotype 3, isolated from a penicillin-allergic patient and initially susceptible to fluoroquinolones, macrolides, lincosamides, quinupristin-dalfopristin, and telithromycin, became resistant to all these drugs during treatment. Mutations in the parC and gyrA and in the 23S rRNA and the ribosomal protein L22 genes were detected in the resistant isolates.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Infective Agents / therapeutic use*
  • Drug Resistance, Multiple, Bacterial*
  • Fluoroquinolones
  • Humans
  • Macrolides
  • Male
  • Microbial Sensitivity Tests
  • Pneumococcal Infections / drug therapy*
  • Point Mutation
  • Streptococcus pneumoniae / drug effects*
  • Streptococcus pneumoniae / genetics
  • Treatment Failure


  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Fluoroquinolones
  • Macrolides