Community prescribing and resistant Streptococcus pneumoniae.

Area of Science:

• Microbiology
• Epidemiology
• Pediatrics

Background:

• Acute otitis media is common in children.
• Antimicrobial resistance is a growing public health concern.
• Understanding the link between prescribing patterns and resistance is crucial.

Purpose of the Study:

• To investigate the association between antimicrobial prescribing and Streptococcus pneumoniae resistance in children with acute otitis media.
• To compare resistance patterns between Jewish and Bedouin children in southern Israel.
• To assess the impact of specific antimicrobial agents on resistance trends.

Main Methods:

• Longitudinal study over 6 years.
• Recording antimicrobial prescriptions for children under 5.
• Collecting and analyzing pneumococcal isolates from middle ear fluid.
• Determining minimum inhibitory concentrations (MIC) for penicillin and macrolides.

Main Results:

• Antimicrobial drug use was higher in Bedouin children, but penicillin resistance was higher in Jewish children.
• Antimicrobial prescriptions, particularly penicillins and erythromycin, decreased over time.
• Azithromycin prescriptions increased from 1998-2001, coinciding with increased macrolide and multidrug resistance.
• Penicillin resistance was associated with macrolide resistance.

Conclusions:

• Azithromycin use appears to be associated with increased antimicrobial resistance in Streptococcus pneumoniae.
• This includes increased macrolide and multidrug resistance.
• Findings highlight the need for judicious antimicrobial prescribing to mitigate resistance.