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Streptococcus pneumoniae: Activity of Newer Agents Against Penicillin-Resistant Strains

Jacobs1, Appelbaum

  • 1Department of Pathology, Case Western Reserve University and University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106, USA.

Current Infectious Disease Reports
|November 30, 2000
PubMed

Insights

Antimicrobial resistance in pneumococci is a global concern, with many strains showing resistance to multiple drugs. Understanding resistance patterns is crucial for effective treatment decisions in pneumococcal infections.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Increasing prevalence of antimicrobial resistance in Streptococcus pneumoniae strains worldwide.
  • Significant rates of penicillin and macrolide resistance observed in the United States by 1997.
  • Co-resistance to multiple antimicrobial classes, including beta-lactams and tetracyclines, is common.

Purpose of the Study:

  • To highlight the global challenge of pneumococcal antimicrobial resistance.
  • To inform treatment strategies for pneumococcal infections based on resistance profiles.
  • To emphasize the importance of pharmacokinetic and pharmacodynamic principles in interpreting susceptibility data.

Main Methods:

  • Review of global reports on pneumococcal antimicrobial resistance patterns.
  • Analysis of resistance data from the United States in 1997.
  • Application of pharmacokinetic/pharmacodynamic (PK/PD) principles to pneumococcal susceptibility data.

Main Results:

  • Over 50% of US pneumococcal strains were not susceptible to penicillin in 1997.
  • 30% of US strains exhibited macrolide resistance.
  • Clinically significant resistance impacts meningitis treatment and oral beta-lactam efficacy.

Conclusions:

  • Antimicrobial resistance in pneumococci necessitates careful consideration of infection site, resistance levels, and patient factors for treatment.
  • PK/PD variables enhance the interpretation of susceptibility data and the establishment of clinical breakpoints.
  • Effective management of pneumococcal infections requires a comprehensive understanding of evolving resistance trends.

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