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Utilisation of macrolides and the development of Streptococcus pyogenes resistance to erythromycin

Karel Urbánek1, Milan Kolár, Luboslava Cekanová

  • 1Department of Pharmacology, Faculty of Medicine, Palacký University, Olomouc, Czech Republic. urbanek@fnol.cz

Pharmacy World & Science : PWS
|July 8, 2005
PubMed
Abstract

Insights

Increased macrolide use in the Czech Republic correlated with rising erythromycin resistance in Streptococcus pyogenes. Penicillin remains the preferred treatment for bacterial tonsillitis, with macrolides reserved for penicillin-allergic patients.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Macrolide antibiotics are widely used for bacterial infections.
  • Streptococcus pyogenes is a common cause of bacterial tonsillitis.
  • Antibiotic resistance is a growing global health concern.

Purpose of the Study:

  • To investigate the link between macrolide consumption and erythromycin resistance in Streptococcus pyogenes.
  • To analyze antibiotic prescribing trends in the Olomouc region, Czech Republic.

Main Methods:

  • Retrospective analysis of macrolide utilization data (1997-2001).
  • Isolation and antibiotic susceptibility testing (disk diffusion) of S. pyogenes strains from patients with acute bacterial tonsillitis.
  • Statistical analysis of resistance trends and antibiotic usage.

Main Results:

  • Macrolide utilization increased by 13% from 1997 to 2001.
  • Erythromycin resistance in S. pyogenes rose significantly from 14% to 32% during the study period.
  • Despite a temporary decrease in macrolide use, resistance did not decline, highlighting a sustained impact.

Conclusions:

  • Increased macrolide utilization is associated with the development of erythromycin resistance in S. pyogenes.
  • Penicillin is recommended as the first-line treatment for acute bacterial tonsillitis.
  • Macrolides should be reserved for patients with penicillin allergies to preserve their efficacy.

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