The drug-resistant pneumococcus: clinical relevance, therapy, and prevention

Streptococcus pneumoniae has been known for > 100 years as the most important bacterial pathogen of the respiratory tract in adults and children. In recent years, the pneumococcus has begun to exhibit increasing resistance to antimicrobial agents. Because of the huge number of infections caused by this organism, the development of resistance has changed the approach to many infectious disease problems, particularly with regard to empiric antibiotic therapy and prophylaxis. In our review of the antibiotic-resistant pneumococcus, we review the microbiologic basis for resistance, risk factors for and clinical relevance of infection by a resistant organism, and infection control measures.