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Macrolide prescriptions and erythromycin resistance of Streptococcus pyogenes

Carlo Gagliotti1, Lucia Nobilio, Milena Milandri

  • 1Agenzia Sanitaria Regionale Emilia-Romagna, Bologna, Italy. cgagliotti@regione.emilia-romagna.it

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 1, 2006
PubMed

Insights

High macrolide antibiotic use in Italy correlates with increased erythromycin resistance in Streptococcus pyogenes bacteria among children. Recent macrolide prescriptions, particularly azithromycin, predict this growing resistance.

Area of Science:

  • Microbiology
  • Public Health
  • Infectious Diseases

Background:

  • Streptococcus pyogenes is a common bacterial pathogen.
  • Macrolide antibiotics, including azithromycin, are frequently prescribed for bacterial infections.
  • Erythromycin resistance in S. pyogenes is a growing public health concern.

Purpose of the Study:

  • To investigate the association between macrolide prescription rates and erythromycin resistance in Streptococcus pyogenes.
  • To identify predictors of macrolide resistance in pediatric populations.

Main Methods:

  • Retrospective analysis of macrolide prescriptions reimbursed by the Italian National Health Service.
  • Correlation analysis with Streptococcus pyogenes erythromycin resistance data from a specific region in northern Italy.

Main Results:

  • A significant association was found between the number of macrolide prescriptions and S. pyogenes erythromycin resistance.
  • Recent macrolide use, especially azithromycin, was identified as a predictor of erythromycin resistance.
  • Community-level risk factors for resistance were also suggested.

Conclusions:

  • Macrolide antibiotic stewardship is crucial to mitigate the rise of erythromycin resistance in Streptococcus pyogenes.
  • Targeted interventions may be needed in areas with high macrolide prescription prevalence.
  • Understanding prescription patterns is key to combating antibiotic resistance.

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