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Community prescribing and resistant Streptococcus pneumoniae

Galia Barkai1, David Greenberg, Noga Givon-Lavi

  • 1Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Emerging Infectious Diseases
|June 21, 2005
PubMed

Insights

Increased azithromycin use in children with acute otitis media correlated with higher antimicrobial resistance in Streptococcus pneumoniae. This suggests a link between azithromycin prescriptions and rising resistance, including multidrug resistance.

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.

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