1. Successful use of azithromycin for Escherichia coli-associated renal allograft malakoplakia: a report of two cases.
- Author
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Kinsella PM, Smibert OC, Whitlam JB, Steven M, Masia R, Gandhi RG, Kotton CN, and Holmes NE
- Subjects
- Escherichia coli drug effects, Escherichia coli genetics, Escherichia coli physiology, Escherichia coli Infections microbiology, Female, Humans, Malacoplakia etiology, Malacoplakia microbiology, Microbial Sensitivity Tests, Middle Aged, Postoperative Complications etiology, Postoperative Complications microbiology, Allografts microbiology, Anti-Bacterial Agents administration & dosage, Azithromycin administration & dosage, Escherichia coli Infections drug therapy, Kidney Transplantation adverse effects, Malacoplakia drug therapy, Postoperative Complications drug therapy
- Abstract
Malakoplakia is a chronic granulomatous disease associated with incomplete clearance of bacterial pathogens. A multimodal approach to therapy includes antimicrobials with intracellular activity, reduction in immunosuppression, and debulking of lesions. Azithromycin has an intracellular mechanism of action and enhanced Gram-negative activity compared to other macrolides. Despite some in vitro data to support its use, there are no clinical breakpoints or epidemiological cut-off values for most Enterobacterales from the European Committee on Antimicrobial Susceptibility Testing (EUCAST) or the Clinical and Laboratory Standards Institute (CLSI). We present two cases, previously unreported, of Escherichia coli associated renal allograft malakoplakia successfully treated with azithromycin., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2021
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