Resistance to ciprofloxacin appearing during therapy

The American Journal of Medicine
N X ChinH C Neu

Abstract

The development of resistance to ciprofloxacin in nine clinical isolates of Pseudomonas aeruginosa was investigated. Isolates had increases in minimal inhibitory concentrations (MICs) from 0.25 to 16 micrograms/ml. The isolates also became resistant to ofloxacin and norfloxacin, but did not show increases in MICs to aminoglycosides, antipseudomonas penicillins, or cephalosporins. One isolate from a patient with endocarditis showed a reduction in a 43-kD outer membrane protein and simultaneous increase in the imipenem MIC. This isolate also showed impaired uptake of ciprofloxacin. Respiratory isolates from cystic fibrosis patients did not show loss of outer membrane protein. MICs were lowered by ethylene diaminetetra-acetic acid, suggesting changes in lipopolysaccharide. Resistant isolates were synergistically inhibited by combinations of ciprofloxacin plus tobramycin or ceftazidime, but MICs remained beyond the achievable serum level.

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Citations

May 1, 1995·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·J A García-RodríguezI Trujillano
Feb 27, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Donald P LevineKenneth Tack
Oct 1, 1991·Antimicrobial Agents and Chemotherapy·M Michéa-HamzehpourJ C Pechère
Mar 1, 1991·Antimicrobial Agents and Chemotherapy·M Michea-HamzehpourJ C Pechere
Dec 1, 1993·Antimicrobial Agents and Chemotherapy·S A Marshall, R N Jones
Mar 1, 1995·Antimicrobial Agents and Chemotherapy·H FukudaK Hirai
Nov 30, 1989·The American Journal of Medicine·H C NeuF Briones
Oct 31, 2001·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·J RobertV Jarlier
Aug 18, 2000·The Journal of Immunology : Official Journal of the American Association of Immunologists·M M SadeghiJ R Bender
Jan 1, 1996·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Isamu SaikawaYasuo Watanabe

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