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Predicting fluoroquinolones ability to kill resistant streptococcus pneumoniae isolates expressing different genetic mutations: target attainment analysis simulating therapeutic doses to patients with community acquired pneumonia

Ayman M. Noreddin

Streptococcal pneumonia is a major cause of morbidity and mortality worldwide. Fluoroquinolones are one of the mainstay drugs for treatment of these infections. However emerging resistance poses a threat to the class’s future utility. Using Monte Carlo simulation, we evaluated the probable efficacy of ciprofloxacin, levofloxacin, gemifloxacin, garenoxacin, and moxifloxacin in eradicating infections and preventing continued growth of resistance. Methods: Using patient data from strep pneumonia patients in hospitals and MIC data from the CROSS study, drug regimens were compared to see the likelihood of attaining fAUC0-24/ MICall ratios depicting goal clinical outcomes. Conclusions: Very few regimens are able to prevent further growth of resistant organisms when ParC mutations have occurred. Only garenoxacin and moxifloxacin were able to eradicate extremely resistant isolates in serum and ELF respectively.