Hidden Epidemic of Macrolide-resistant Pneumococci

• Type of Material: Article
• Authors: Keith P Klugman, Emory University; John R Lonks, Brown Medical School
• Language: English
• Date: 2005-06
• Publisher: U.S. National Center for Infectious Diseases
• Publication Version: Final Published Version
• Copyright Statement: Emerging Infectious Diseases is published by the Centers for Disease Control and Prevention, a U.S. Government agency. Therefore, all materials published in Emerging Infectious Diseases are in the public domain and can be used without permission.
• Final Published Version (URL): http://wwwnc.cdc.gov/eid/article/11/6/05-0147_article.htm
• Title of Journal or Parent Work: Emerging Infectious Diseases
• ISSN: 1080-6040
• Volume: 11
• Issue: 6
• Start Page: 802
• End Page: 807
• Grant/Funding Information: Keith Klugman has received research funding and consultation fees from Aventis, Bayer, GlaxoSmithKline, Oscient Pharmaceuticals, and Roche.; John Lonks has received research funding from Bristol-Myers Squibb and Aventis and consultation fees from Aventis.; The PROTEKT study is supported by sanofi-aventis.
• Keywords: Streptococcus pneumoniae; Macrolides; Treatment failure; Antibiotic resistance; Community-acquired infections
• Research Categories: Health Sciences, General; Health Sciences, Pharmacology

Abstract

Community-acquired respiratory tract infections (RTIs) account for a substantial proportion of outpatient antimicrobial drug prescriptions worldwide. Concern over the emergence of multidrug resistance in pneumococci has largely been focused on penicillin-resistant Streptococcus pneumoniae. Macrolide antimicrobial drugs have been widely used to empirically treat community-acquired RTIs because of their efficacy in treating both common and atypical respiratory pathogens, including S. pneumoniae. However, increased macrolide use has been associated with a global increase in pneumococcal resistance, which is leading to concern over the continued clinical efficacy of the macrolides to treat community-acquired RTIs. We provide an overview of macrolide-resistant S. pneumoniae and assess the impact of this resistance on the empiric treatment of community-acquired RTIs.