Antibiotic consumption and resistance selection in Streptococcus pneumoniae

Area of Science:

• Microbiology
• Epidemiology
• Public Health

Background:

• Antibiotic resistance in Streptococcus pneumoniae is a significant global health concern.
• Antibiotic consumption directly correlates with the selection and prevalence of resistant bacterial strains across all ecological levels.
• Multiple drug resistance intensifies antibiotic selection pressure, with varying selective powers among different antibiotic classes.

Purpose of the Study:

• To analyze the relationship between antibiotic consumption and the selection of antibiotic-resistant Streptococcus pneumoniae.
• To investigate the asymmetrical co-selection phenomenon between macrolide and beta-lactam resistance.
• To explore sociobiological determinants influencing antibiotic consumption and propose strategies for control.

Main Methods:

• Review of ecological levels of antibiotic resistance correlation.
• Analysis of asymmetrical co-selection dynamics for macrolide and beta-lactam resistance.
• Identification of sociobiological factors influencing antibiotic consumption patterns.

Main Results:

• Antibiotic use inevitably selects for resistant Streptococcus pneumoniae.
• Macrolides exhibit a more efficient co-selection of resistance to both macrolides and beta-lactams compared to aminopenicillins.
• Factors such as genetic predispositions, cultural attitudes, and public health issues influence antibiotic consumption.

Conclusions:

• Antibiotic resistance is a direct consequence of antibiotic use, necessitating control over 'excess' consumption.
• The concept of 'appropriate demand for antibiotics' (ADA) is proposed to manage antibiotic usage effectively.
• Understanding the sociobiological determinants of antibiotic consumption is crucial for developing targeted interventions.