Resistance to Quinolones

Overview

Journal Pharm Weekbl Sci

Specialty Pharmacy

Date 1987 Dec 11

PMID 3125517

Authors

R P Mouton

Affiliations

Soon will be listed here.

Abstract

Resistance to quinolones is only due to mutations. The mechanism and the range of quinolones involved, depend on the locus of the chromosomal mutation e.g. a mutation in the gyr A locus is associated with resistance due to changes in the gyrase. Using high inocula in vitro, varying, but relatively low mutation rates of resistance to fluoroquinolones have been found (10(-6)-10(-12). In vitro transfers of bacterial strains in increasing concentrations of quinolones yield parallel increases of the MIC's of most quinolones; however, the MIC's of the most active quinolones like ciprofloxacin usually remain below concentrations achievable in vivo. Exceptions are MIC's for Pseudomonas aeruginosa and staphylococci. Combined resistance to quinolones and other antibiotics was observed after in vitro transfers as well as in mutants (10(-6)-10(-8) isolated from a high inoculum. Changes in the outer membrane proteins have been found in these mutants. Clinical resistance to fluoroquinolones is rare except in Pseudomonas aeruginosa and staphylococci.

References

Chapman S, Speller D, Reeves D . Resistance to ciprofloxacin. Lancet. 1985; 2(8445):39. DOI: 10.1016/s0140-6736(85)90083-2. View

Piddock L, Diver J, Wise R . Cross-resistance of nalidixic acid resistant Enterobacteriaceae to new quinolones and other antimicrobials. Eur J Clin Microbiol. 1986; 5(4):411-5. DOI: 10.1007/BF02075696. View

Hirai K, Aoyama H, SUZUE S, IRIKURA T, Iyobe S, Mitsuhashi S . Isolation and characterization of norfloxacin-resistant mutants of Escherichia coli K-12. Antimicrob Agents Chemother. 1986; 30(2):248-53. PMC: 180528. DOI: 10.1128/AAC.30.2.248. View

Mouton R, Mulders S . Combined resistance to quinolones and beta-lactams after in vitro transfer on single drugs. Chemotherapy. 1987; 33(3):189-96. DOI: 10.1159/000238494. View

Smith J . The mode of action of 4-quinolones and possible mechanisms of resistance. J Antimicrob Chemother. 1986; 18 Suppl D:21-9. DOI: 10.1093/jac/18.supplement_d.21. View

Ronald A, Turck M, Petersdorf R . A critical evaluation of nalidixic acid in urinary-tract infections. N Engl J Med. 1966; 275(20):1081-9. DOI: 10.1056/NEJM196611172752001. View

Sanders C, Sanders Jr W, Goering R, Werner V . Selection of multiple antibiotic resistance by quinolones, beta-lactams, and aminoglycosides with special reference to cross-resistance between unrelated drug classes. Antimicrob Agents Chemother. 1984; 26(6):797-801. PMC: 180026. DOI: 10.1128/AAC.26.6.797. View

Bachmann B, Low K, Taylor A . Recalibrated linkage map of Escherichia coli K-12. Bacteriol Rev. 1976; 40(1):116-67. PMC: 413944. DOI: 10.1128/br.40.1.116-167.1976. View

Duckworth G, Williams J . Frequency of appearance of resistant variants to norfloxacin and nalidixic acid. J Antimicrob Chemother. 1984; 13 Suppl B:33-8. DOI: 10.1093/jac/13.suppl_b.33. View

10.

Cullmann W, Stieglitz M, Baars B, Opferkuch W . Comparative evaluation of recently developed quinolone compounds--with a note on the frequency of resistant mutants. Chemotherapy. 1985; 31(1):19-28. DOI: 10.1159/000238309. View

11.

Smith G, Cashmore C, Leyland M . Ciprofloxacin-resistant staphylococci. Lancet. 1985; 2(8461):949. DOI: 10.1016/s0140-6736(85)90880-3. View

12.

Humphreys H, Mulvihill E . Ciprofloxacin-resistant Staphylococcus aureus. Lancet. 1985; 2(8451):383. DOI: 10.1016/s0140-6736(85)92510-3. View

13.

Roberts C, Batten J, Hodson M . Ciprofloxacin-resistant Pseudomonas. Lancet. 1985; 1(8443):1442. DOI: 10.1016/s0140-6736(85)91862-8. View

14.

Follath F, Bindschedler M, Wenk M, Frei R, Stalder H, Reber H . Use of ciprofloxacin in the treatment of Pseudomonas aeruginosa infections. Eur J Clin Microbiol. 1986; 5(2):236-40. DOI: 10.1007/BF02013997. View

15.

Scribner R, Welch D, Marks M . Low frequency of bacterial resistance to enoxacin in vitro and in experimental pneumonia. J Antimicrob Chemother. 1985; 16(5):597-603. DOI: 10.1093/jac/16.5.597. View