1 Macrolide 1 antibacterial activity antibacterial activity - - PowerPoint PPT Presentation

Macrolide Macrolide1

1

antibacterial activity antibacterial activity in bacteria in bacteria2

2

without resistance without resistance mechanisms mechanisms to to macrolide antibiotics macrolide antibiotics

G Kahlmeter

Clinical microbiology Central hospital 351 85 Växjö Sweden

1 1azithromycin,

azithromycin, clarithromycin clarithromycin, ,

erythromycin

erythromycin, , roxithromycin roxithromycin, , telithromycin telithromycin

2 2bacteria for

bacteria for which macrolide antibiotics are used which macrolide antibiotics are used

Macrolide activity expressed as MIC (broth or agar dilution) or IC (Etest) values (mg/L). Data from the Swedish Reference Group of Antibiotics (SRGA, SRGA-M; see MIC-table in www.srga.org), and a synthesis of data from a large number of articles. The last slide shows reproducibility of disc diffusion over time.

0,004 0,008 0,016 0,032 0,064 0,125 0,25 0,5 1 2 4 8 16 32 64 128 >256

50 100 150 200 Ciprofloxacin Tetracycline Clindamycin Benzylpenicillin Telithromycin Erythromycin

Streptococcus pyogenes

n=199 clinical isolates (B.Olsson-Liljequist, Sweden)

0,004 0,008 0,016 0,032 0,064 0,125 0,25 0,5 1 2 4 8 16 32 64 128 >256 50 100 150 200 Ciprofloxacine Tetracycline Clindamycin Bensylpenicillin Telithromycin Erythromycin

Streptococcus pneumoniae

n=199 clinical isolates (B.Olsson-Liljequist, Sweden)

Erythromycin - MIC distributions of isolates that lack resistance mechanisms Mg/L .004 .008 .016 .032 .064 .125 .25 .5 1 2 4 8 16 32 >64 S.aureus ! ! ! ! Coag-neg staph ! ! ! S.saprophyticus ! ! ! Streptococcus_A ! ! ! Streptococcus_B ! ! ! Pneumococci ! ! ! Strept misc ! ! ! ! Enterococcus ! ! ! ! ! Listeria ! ! ! Corynebacteria ! ! ! Bacillus spp ! ! ! H.influenzae ! ! ! ! ! AST M.catarrhalis ! ! ! B.pertussis ! ! ! ! P.multocida ! ! !

• L. pneumophila

! ! ! !

• Camp. jejuni

! ! ! N.gonorrhoeae ! ! ! ! N.meningitidis ! ! ! ! M.pneumoniae ! ! ! !

• Borr. burgdorferi

! ! ! SRGA and SRGA- M, 1998-04-13, 2001-11-11 G Kahlmeter & B.Olsson-Liljequist

Roxithromycin – MIC-distributions of isolates that lack resistance mechanisms. Mg/L

.004 .008 .016 .032 .064 .125 .25 .5 1 2 4 8 16 32 >64

S.aureus ! ! ! Coag-neg staph ! ! ! S.saprophyticus ! ! ! Streptococcus_A ! ! ! Streptococcus B ! ! ! Pneumococci ! ! ! Strept misc ! ! ! Enterococcus ! ! ! ! ! Listeria ! ! Corynebacteria ! ! ! Bacillus spp ! ! ! H.influenzae ! ! ! M.catarrhalis ! ! !

• B. pertussis

! ! ! !

• Bor. burgdorferi

! ! ! ! H.pylori ! ! !

SRGA and SRGA- M, 1998-04-13, 2001-11-11 G Kahlmeter & B.Olsson-Liljequist

Clarithromycin - MIC-distributions of isolates that lack resistance mechanisms. Mg/L .004 .008 .016 .032 .064 .125 .25 .5 1 2 4 8 16 32 >64 S.aureus ! ! ! Coag-neg staph ! ! ! S.saprophyt ! ! ! Streptococcus_A ! ! ! Streptococcus_B ! ! ! Pneumococci ! ! ! Strept misc ! ! ! Enterococcus ! ! ! Listeria ! ! Corynebacteria ! ! ! Bacillus sp ! ! ! H.influenzae ! ! ! ! M.catarrhalis ! ! !

• M. pneumoniae

! ! ! ! ! !

• Bor. burgdorferi

! ! ! Helicobacter ! ! ! !

SRGA and SRGA- M, 1998-04-13, 2001-11-11, G Kahlmeter G Kahlmeter & B.Olsson-Liljequist

Azitromycin - MIC-distributions of strains that lack resistance mechanisms. Mg/L .004 .008 .016 .032 .064 .125 .25 .5 1 2 4 8 16 32 >64 S.aureus ! ! ! Coag-neg staph ! ! ! S.saprophyticus ! ! ! Streptococcus_A ! ! ! Streptococcus_B ! ! ! Pneumococci ! ! ! ! Strept misc ! ! ! Enterococcus ! ! ! ! ! H.influenzae ! ! ! ! M.catarrhalis ! ! !

• Bor. burgdorferi

! ! H.pylori ! !

SRGA and SRGA- M, 1998-04-13, 2001-11-11 G Kahlmeter & B.Olsson-Liljequist

Telithromycin - MIC-distributions of isolates that lack resistance mechanisms Mg/L .004 .008 .016 .032 .064 .125 .25 .5 1 2 4 8 16 32 >64 S.aureus ! ! ! Coag-neg staph ! ! ! S.saprophyt ! ! ! Streptococcus_A ! ! ! Streptococcus_B ! ! ! Pneumococci ! ! ! Strept misc ! ! ! E.faecalis ! ! ! !

• E. faecium

! ! ! Listeria ! ! ! H.influenzae ! ! ! M.catarrhalis ! ! ! ! N.meningitidis ! ! ! Helicobacter ! ! ! ! ! ! Clostridium spp ! ! ! !

SRGA and SRGA- M, 2001-05-05 G Kahlmeter & B.Olsson-Liljequist

Zone diameter (mm)

%

6 19 23 30 40

5 10 15 20 25 1999 1998 1997 1996 1995 1994 1993 1992 1991 Erythromycin 15 µg on ISA with horse blood 400 - 1100 isolates per year

Streptococcus pyogenes

ECCMID2000:29 2000-05-22 G Kahlmeter