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The primary outcome was microbiologic failure.
The other two patients in whom microbiologic failure occurred had superinfections.
Surprisingly, microbiologic failure occurred only when >60% of doses were missed, but no ADR was encountered.
Endpoints were microbiologic failure, relapse, and ADR in patients on either DOT or SAT.
This may explain the suggested association between rural residence and microbiologic failure.
Microbiologic failure refers to positive smear microscopy or culture at the fifth month or later on therapy.
Similar(32)
Despite early skepticism, increasing evidence shows that in vitro macrolide resistance does result in clinical and microbiologic failures in systemic pneumococcal infection (22, 23 ).
One of the 2 patients treated with oral amoxicillin experienced a clinical and microbiologic treatment failure 48 hours after completion, but a clinical and microbiologic cure was achieved after treatment with oral azithromycin.
In recent years, several reports have described clinical and microbiologic treatment failures that have occurred in hospitalized patients infected with macrolide-resistant pneumococci (31).
In recent years, a number of studies have clearly linked in vitro macrolide resistance to microbiologic and clinical treatment failure, indicating that macrolide resistance is an emerging problem.
The low yield of microbiologic sampling and the failure of a wide spectrum, empirical anti-bacterial treatment are clues that should prompt clinicians to include invasive mycosis in the differential diagnosis of septic arthritis in immunocompromised patients.
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