zithromax and Malacoplakia

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.

Topics: Allografts; Anti-Bacterial Agents; Azithromycin; Escherichia coli; Escherichia coli Infections; Female; Humans; Kidney Transplantation; Malacoplakia; Microbial Sensitivity Tests; Middle Aged; Postoperative Complications

Topics: Aged; Anti-Bacterial Agents; Azithromycin; Biopsy; Bronchi; Bronchography; Diagnosis, Differential; Dyspnea; Female; Hemoptysis; Humans; Kidney Transplantation; Levofloxacin; Malacoplakia; Tomography, X-Ray Computed