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From 1997 to 1999, 94 study centers in 15 European, 3 North American, and 2 South American countries contributed 2,632 isolates ofStreptococcus pneumoniae to an international antimicrobial susceptibility testing study. Only 62.0% of isolates were susceptible to penicillin, while 22.3% were penicillin intermediate and 15.6% were penicillin resistant. Resistance to trimethoprim-sulfamethoxazole (24.4%), azithromycin (26.0%), and clarithromycin (27.1%) was also highly prevalent. For the penicillin-resistant isolates (n = 411), the MICs at which 90% of isolates are inhibited (MIC90 s) for gemifloxacin, levofloxacin, ofloxacin, clarithromycin, and azithromycin were 0.03, 1, 2, &gt;16, and &gt;64 μg/ml, respectively. Similarly, for isolates resistant to both azithromycin and clarithromycin (n = 649), gemifloxacin, levofloxacin, ofloxacin, and penicillin MIC90 s were 0.03, 1, 2, and 4 μg/ml, respectively. Overall rates of resistance to trovafloxacin (0.3%), levofloxacin (0.3%), grepafloxacin (0.6%), and ofloxacin (0.7%) were low. For ofloxacin-intermediate and -resistant isolates (n = 142), gemifloxacin had the lowest MIC90 (0.12 μg/ml) compared to the MIC90 s of trovafloxacin (0.5 μg/ml), grepafloxacin (1 μg/ml), and levofloxacin (2 μg/ml). For allS. pneumoniae isolates tested, gemifloxacin MICs were ≤0.5 μg/ml, suggesting that gemifloxacin has the potential to be used as a treatment for pneumococcal infections, including those arising from isolates resistant to β-lactams and macrolides.

antimicrobial agents and chemotherapy

A Comparative In Vitro Surveillance Study of Gemifloxacin Activities against 2,632 Recent Streptococcus pneumoniae Isolates from across Europe, North America, and South America