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A chronic prostatitis patient was prescribed Levofloxacin after the culture sensitivity test of his prostatic fluid was done, in which Levofloxacin was highly sensitive.. After taking 15 days course of Levofloxacin, the patient visited his urologist again and said that he had gotten 40% relief in his symptoms.. Then the doctor prescribed him Nitrofurantoin.. After taking it for 5 days, patient visited the doctor again complaining that his symptoms are getting worse inspite of improving.. The doctor asked him to start Levofloxacin again.. He did that but this time, even after taking Levoflox for 7 days, he didn't improve..

Is it possible in this case that the patient has developed Levoflox resistance?
 

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It is possible that the pt has developed cross resistance from other quinolones....from what i can gather from my study another reason could be at hand. The emergence of resistance, particularly among the Gram-positives has been a problem. One reason leading to this is the use of fluoroquinolone prophylactically in neutropenic patients. Prophylaxis promotes resistance so I think this is one area where fluoroquinolones should not be used. If you introduce one drug on a regular low dose schedule for a prolonged period of time in neutropenic patients, resistance will develop....and one of the cause of neutropenia could be bacterial infections, in this case chronic bacterial prostatitis if thats what the patient has resistance could be attributed to that, but i'm still in the understanding phase as i study for the step 1 so this is all I gathered from what i've studied so far!

hope it helps
 
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