By Mark Abramowicz

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Some strains of S. pneumoniae are resistant to erythromycin, clindamycin, trimethoprim-sulfamethoxazole, clarithromycin, azithromycin and chloramphenicol, and resistance to the newer fluoroquinolones is rare but increasing (R Davidson et al, N Engl J Med 2002; 346:747). Nearly all strains tested so far are susceptible to linezolid and quinupristin/dalfopristin in vitro. 15. Fluoroquinolone-resistant strains of gonococcus are increasingly common (MMWR, Morb Mortal Wkly Rep 2002; 51:1041; KA Fenton et al, Lancet 2003; 361:1867).

Staphylococcus aureus 2. Streptococcus pyogenes (Group A) 3. Pseudomonas aeruginosa (or other gram-negative bacilli) 35 Pathogens Skin infections 1. Staphylococcus aureus 2. Streptococcus pyogenes (Group A) 3. Dermatophytes 4. Candida spp. and other fungi 5. Herpes simplex or zoster 6. Gram-negative bacilli 7. Treponema pallidum 8. Borrelia burgdorferi 9. Bartonella henselae or quintana 10. Bacillus anthracis Decubitus Wound infections 1. Staphylococcus aureus 2. Escherichia coli (or other gram-negative bacilli) 3.

Enteric gram-negative bacteria cause meningitis especially in neonates, the elderly, and in those who have had recent neurosurgery or are immunosuppressed. Group B streptococcus often causes meningitis in neonates. Listeria monocytogenes may be the cause in pregnant women and newborns, and also in the elderly or immunosuppressed (X Sáez-Llorens and GH McCracken Jr, Lancet 2003; 361:2139). For treatment of meningitis in adults and in children more than two months old, pending results of cultures, high-dose ceftriaxone or cefotaxime is generally recommended, plus vancomycin to cover cephalosporin-resistant pneumococci.

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