Antofloxacin

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Antofloxacin Development of resistant mutations: case report

A 48-year-old man exhibited presence of resistant mutations following antibacterial treatment with antofloxacin for urethritis due to Mycoplasma genitalium [route, time to reaction onset and outcome of ADR not stated]. The man presented with a 2-month history of persistent urethral irritation and urethral discharge. Previously, he had tested positive for Chlamydia trachomatis, for which he was initially treated with azithromycin and minocycline. He experienced a mild improvement of urethral irritation following the treatment, but the symptoms never resolved fully. Following examination, he was diagnosed with urethritis due to Mycoplasma genitalium infection. Therefore, he started receiving antibacterial [antibiotic] therapy with antofloxacin 200mg once a day for 7 days [route not stated], followed by azithromycin. However, he still tested positive for Mycoplasma genitalium. Forty-two days after the initial presentation, he reported urethral irritation and discharge. Then, he was treated with moxifloxacin, followed by minocycline. After treatment, he only had a mild urethral irritation (mild improvement from earlier symptoms) at the time of third visit (92 days after initial presentation), and he started receiving antofloxacin 200mg once a day along with rifampicin [rifampin]. However, he still had mild urethral irritation. Then, he was treated with azithromycin and spectinomycin, leading to improvement of the symptoms. Eventually, he was treated with doxycycline. Thereafter, he was symptom-free, and he tested negative for Mycoplasma genitalium. Mutations, such as A2072G mutation in 23S rRNA, Ser83IIe mutation in parC and Gly93Cys mutation in gyrA, were detected in Mycoplasma genitalium. It was determined that that the therapy with antofloxacin might have induced these mutations in parC and gyrA, which conferred resistance to quinolones. Yang L, et al. Azithromycin, minocycline, moxifloxacin and spectinomycin failure in a case with persistent Mycoplasma genitalium infection in Guangzhou, China. International Journal of STD and AIDS 31: 1106-1109, No. 11, 2020. Available from: URL: http://doi.org/10.1177/0956462420905269

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Reactions 28 Nov 2020 No. 1832

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