Will reduction of antibiotic use reduce antibiotic resistance?: The pneumococcus paradigm

Area of Science:

• Pediatric infectious diseases
• Antimicrobial resistance
• Pharmacology

Background:

• Community-acquired respiratory infections are a primary reason for antibiotic use in children.
• Widespread antibiotic use contributes to the emergence of antimicrobial resistance.
• Differences in resistance promotion potential among antibiotics are often overlooked.

Purpose of the Study:

• To review antibiotic prescribing trends in young children.
• To examine the relationship between antibiotic use and *Streptococcus pneumoniae* resistance.
• To identify antibiotics with the lowest resistance-promotion potential.

Main Methods:

• Review of antibiotic prescribing patterns in pediatric populations.
• Analysis of clinical respiratory isolates of *S. pneumoniae*.
• Evaluation of theoretical considerations and research evidence on antibiotic resistance promotion.

Main Results:

• Amoxicillin (+/- clavulanate) showed the least resistance-promoting effect against *S. pneumoniae*.
• Oral cephalosporins and azithromycin exhibited higher resistance-promotion potential.
• All reviewed antibiotics contribute to the promotion of antimicrobial resistance.

Conclusions:

• Antibiotic choice significantly impacts resistance development in *S. pneumoniae*.
• Amoxicillin is a preferred agent for reducing resistance promotion in pediatric respiratory infections.
• Strategies to reduce antibiotic resistance must consider differential resistance promotion potentials.