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Resistance in respiratory tract pathogens: an international study 1997-1998
1MRL Pharmaceutical Services, Brentwood, TN 37027, USA. cthornsberry@thetsn.com
Abstract:
Multiple antibiotic resistance threatens current treatment for community-acquired pneumonia (CAP). This paper presents a summary of resistance data for Streptococcus pneumoniae (6,223 isolates), Haemophilus influenzae (4,016) and Moraxella catarrhalis (1,263) collected from 153 centers throughout Japan, China, UK, Germany, Spain, France, Italy, Brazil and USA. Antiobiotics tested were: beta-lactams (penicillin, ampicillin, co-amoxiclav, cefuroxime, and ceftriaxone), macrolides (azithromycin and clarithromycin), sulphonamide (trimethoprim-sulfamethoxazole), glycopeptide (vancomycin) and fluoroquinolone (levofloxacin). S. pneumoniae with reduced susceptibility to penicillin were predominant in France, Spain and Japan (54-65%), ,beta-lactamase-producing H. influenzae most common in the USA, France and Spain (>25%) and most M. catarrhalis produced beta-lactamase irrespective of origin. S. pneumoniae susceptibility to azithromycin and clarithromycin varied widely. Levofloxacin was active against almost all isolates in all countries and none was resistant to vancomycin. Because of increasing resistance to older drugs, the newer fluoroquinolones have a role in the therapy of CAP and other respiratory infections, although surveillance studies must continue.
Insights
Antibiotic resistance in common pneumonia pathogens like Streptococcus pneumoniae is a growing concern. Fluoroquinolones show broad activity against these bacteria, offering a potential treatment option.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Rising antibiotic resistance in pathogens causing community-acquired pneumonia (CAP) poses a significant clinical challenge.
- Key bacterial culprits include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
Purpose of the Study:
- To summarize antibiotic resistance patterns for major respiratory pathogens across multiple countries.
- To evaluate the in vitro activity of various antibiotic classes against these pathogens.
Main Methods:
- Analysis of 11,302 bacterial isolates (S. pneumoniae, H. influenzae, M. catarrhalis) from 153 international centers.
- Testing susceptibility to beta-lactams, macrolides, sulfonamides, vancomycin, and fluoroquinolones.
Main Results:
- High rates of penicillin non-susceptibility in S. pneumoniae were observed in France, Spain, and Japan.
- Beta-lactamase production was common in H. influenzae (especially in the USA, France, Spain) and M. catarrhalis.
- Levofloxacin demonstrated high activity against nearly all tested isolates; vancomycin showed no resistance.
Conclusions:
- Increasing resistance to older antibiotics necessitates exploring newer agents for CAP treatment.
- Fluoroquinolones, like levofloxacin, represent a valuable therapeutic option for respiratory infections.
- Continued surveillance of antimicrobial resistance is crucial for effective treatment strategies.