Resistance studies with Streptococcus pneumoniae using an in vitro dynamic model: amoxicillin versus azithromycin at clinical exposures.

Resistance studies with Streptococcus pneumoniae using an in vitro dynamic model: amoxicillin versus azithromycin at clinical exposures. J Chemother. 2019 Jun 08;:1-9 Authors: Golikova MV, Strukova EN, Portnoy YA, Dovzhenko SA, Kobrin MB, Zinner SH, Firsov AA Abstract Current knowledge of the emergence of Streptococcus pneumoniae resistance during treatment with aminopenicillins and macrolides is limited. In particular, clinical reports on isolation of azithromycin-resistant mutants do not relate their enrichment to the actual antibiotic concentrations in blood. In the present work, the selection of amoxicillin- and azithromycin-resistant S. pneumoniae mutants at therapeutic and subtherapeutic antibiotic exposures was studied in an in vitro dynamic model. There was no enrichment of S. pneumoniae mutants resistant to amoxicillin, while azithromycin-resistant mutants were enriched in all simulations. This difference was related to the different times above the mutant prevention concentration: 60-100% of the dosing interval for amoxicillin versus zero percentage for azithromycin. These findings are in concordance with the mutant selection window hypothesis. PMID: 31179907 [PubMed - as supplied by publisher]
Source: Journal of Chemotherapy - Category: Cancer & Oncology Tags: J Chemother Source Type: research