Assessment of clinical failures of oral antibiotics resulting in invasive disease

Data on whether the patient had already been prescribed antibiotics for the current episode of infection have been collected for the last 18 months of surveillance. Data are available for 932 episodes of disease. In 87, patients have failed out-patient antibiotics: 35 treated with macrolides (57% of whom had a macrolide resistant isolate), 28 treated with penicillins or cephalosporins (24% of whom had an isolate with reduced susceptibility to penicillin), 20 treated with fluoroquinolones (25% of whom had isolates resistant to levofloxacin), and 4 with other antibiotics. Twenty percent of patients treated with levofloxacin who are subsequently admitted have a levofloxacin resistant isolate.