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.

Malakoplakia 是一种慢性肉芽肿性疾病，与细菌病原体清除不完全有关。多模式治疗方法包括具有细胞内活性的抗微生物剂、减少免疫抑制和减少病变。与其他大环内酯类药物相比，阿奇霉素具有细胞内作用机制和增强的革兰氏阴性菌活性。尽管有一些体外数据支持其使用，但欧洲抗微生物药敏试验委员会 (EUCAST) 或临床和实验室标准研究所 (CLSI)并未针对大多数肠杆菌提供临床断点或流行病学临界值。我们介绍了两例以前未报道过的大肠杆菌相关肾移植物马拉色菌病，这些病例用阿奇霉素成功治疗。