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Macrolide and azithromycin use are linked to increased macrolide resistance in Streptococcus pneumoniae

Miika Bergman1, Solja Huikko, Pentti Huovinen

  • 1Antimicrobial Research Laboratory, Department of Bacterial and Inflammatory Diseases, National Public Health Institute, Kiinamyllynkatu 13, FI-20520 Turku, Finland. miika.bergman@ktl.fi

Antimicrobial Agents and Chemotherapy
|August 31, 2006
PubMed

Insights

Antimicrobial resistance in Streptococcus pneumoniae is linked to regional drug use in Finland. Increased macrolide and azithromycin use correlated with macrolide resistance, while beta-lactam and cephalosporin use linked to penicillin resistance.

Area of Science:

  • Microbiology
  • Epidemiology
  • Pharmacology

Background:

  • Antimicrobial resistance (AMR) is a growing global health concern.
  • Streptococcus pneumoniae is a common cause of bacterial infections, and resistance to antibiotics like penicillin and macrolides is increasing.
  • Understanding the relationship between antimicrobial use and resistance patterns is crucial for effective treatment strategies.

Purpose of the Study:

  • To investigate the association between regional antimicrobial use and resistance rates of Streptococcus pneumoniae in Finland.
  • To determine if specific antibiotic classes (macrolides, penicillins, cephalosporins) correlate with resistance in S. pneumoniae.

Main Methods:

  • Analysis of 31,609 S. pneumoniae isolates for penicillin resistance and 23,769 for macrolide resistance across 18 Finnish hospital districts from 1997-2002.
  • Comparison of regional macrolide resistance rates with pooled macrolide and azithromycin use.
  • Comparison of penicillin resistance levels with consumption data for penicillins, cephalosporins, pooled beta-lactams, and pooled macrolides.

Main Results:

  • A statistically significant association was found between macrolide resistance and the total use of macrolides and azithromycin.
  • Total use of beta-lactams and cephalosporins showed a significant connection to low-level penicillin resistance.
  • No significant association was observed between penicillin-nonsusceptible isolates and penicillin or total macrolide consumption.

Conclusions:

  • Regional macrolide use, including azithromycin, is associated with increased macrolide resistance in S. pneumoniae.
  • Regional beta-lactam and cephalosporin use are linked to increased low-level penicillin resistance in S. pneumoniae.
  • Avoiding unnecessary prescribing of macrolides and cephalosporins is recommended to mitigate resistance development.

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