Bacteremic Pneumonia Due to Multidrug-Resistant Pneumococci in 3 Patients Treated Unsuccessfully with Azithromycin and Successfully with Levofloxacin

Three patients with bacteremic pneumonia caused by multidrug-resistant Streptococcus pneumoniae were treated unsuccessfully with azithromycin. One S. pneumoniae isolate carried a mef determinant for an efflux pump; a second isolate had an erm determinant. All 3 patients were successfully treated with levofloxacin, an antipneumococcal fluoroquinolone.