NEW YORK (Reuters Health) Mar 06 – Canadian researchers writing in the March 7th issue of The New England Journal of Medicine describe four cases of pneumococcal pneumonia in which levofloxacin treatment failed.
The first patient described by Dr. Donald E. Low, from Mount Sinai Hospital, Toronto, and his colleagues was a male, 64 years of age, whose sputum specimen grew Streptococcus pneumoniae which was susceptible to levofloxacin. The patient was treated for 10 days with 500 mg levofloxacin daily. After 10 days symptoms of recurrent pneumonia developed, and a new sputum sample grew levofloxacin-resistant S. pneumoniae.
The second patient, a 37-year-old woman, was treated for levofloxacin-susceptible S. pneumoniae. By the third day of treatment her clinical condition had not improved. A new sputum sample showed the presence of S. pneumoniae that was resistant to levofloxacin.
The third patient a woman, 66 years of age, was treated for community-acquired pneumonia. She had a history of chronic obstructive lung disease and chronic lymphocytic leukemia. She was also allergic to penicillin and had received ciprofloxacin and levofloxacin for a previous acute exacerbation of chronic bronchitis.
On the fifth day of levofloxacin treatment, she developed septic shock and died the following day. Subsequent testing revealed that the initial isolate was resistant to levofloxacin…