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Doxycycline Activity Against Streptococcus pneumoniae

1995; Elsevier BV; Volume: 108; Issue: 6 Linguagem: Inglês

10.1378/chest.108.6.1775-b

1931-3543

Kevin W. Shea, Burke A. Cunha, Yoshio Ueno, Fadwa Abumustafa, S. M. H. Qadri,

Tuberculosis Research and Epidemiology

The choice of empiric antimicrobial therapy for community-acquired respiratory infections is based on pathogens most likely to be encountered. β-Lactam antibiotics are commonly used for both upper and lower respiratory tract infections, and can, in most cases, be used as monotherapy against nonatypical pathogens. Doxycycline, a semisynthetic, second generation tetracycline, has a high degree of activity against all common respiratory pathogens including ampicillin-sensitive-resistant Haemophilus influenzae, β-lactamase-producing strains of Moraxella catarrhalis, and oral pigmented Bacteroides as well as organisms commonly causing atypical pneumonias, eg, Mycoplasma pneumoniae, Legionella pneumophila, or Chlamydia pneumoniae (TWAR agent). Doxycycline has long been used as an effective alternative to β-lactam antibiotics with proven efficacy in the treatment of both upper and lower respiratory tract infections. Doxycycline is now used primarily for the treatment of presumed or proven atypical pneumonias since some physicians are hesitant to use it as monotherapy in community-acquired pneumonia because of presumed inactivity against Streptococcus pneumoniae. Because of widespread resistance of pneumococci to tetracycline physicians have been reluctant to rely on doxycycline for monotherapy of community-acquired pneumonias where S pneumoniae is the most common pathogen, but this should not be equated with doxycycline resistance. Since tetracycline is used in automated susceptibility testing systems, clinicians erroneously assume that S pneumoniae isolates reported resistant to tetracycline are also doxycycline resistant. 1 Appelbaum P.C. Antimicrobial resistance in Streptococcus pneumoniae: an overview. Clin Infect Dis. 1992; 15: 77-83 Crossref PubMed Scopus (852) Google Scholar , 2 Shibl A.M. Hussein S.S. Surveillance of Streptococcus pneumoniae serotypes in Riyadh and their susceptibility to penicillin and other commonly prescribed antibiotics. J Antimicrob Chemother. 1992; 29: 149-157 Crossref PubMed Scopus (33) Google Scholar