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European Journal of Clinical Microbiology & Infectious Diseases

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01-12-2021 | Escherichia Coli | Brief Report

Successful use of azithromycin for Escherichia coli–associated renal allograft malakoplakia: a report of two cases

Authors: Paul M. Kinsella, Olivia C. Smibert, John B. Whitlam, Mark Steven, Ricard Masia, Ronak G. Gandhi, Camille N. Kotton, Natasha E. Holmes

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 12/2021

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.

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Title: Successful use of azithromycin for Escherichia coli–associated renal allograft malakoplakia: a report of two cases
Authors: Paul M. Kinsella
Olivia C. Smibert
John B. Whitlam
Mark Steven
Ricard Masia
Ronak G. Gandhi
Camille N. Kotton
Natasha E. Holmes
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Escherichia Coli
Computed Tomography
Ciprofloxacin
Computed Tomography
Macrolide
Azithromycin
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 12/2021
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-021-04270-x

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