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Clinical impact of antibiotic resistance in respiratory tract infections

Keith P Klugman1

  • 1Hubert Department of Global Health, Rollins School of Public Health, and Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA 30322, USA. keith.klugman@emory.edu

International Journal of Antimicrobial Agents
|February 20, 2007
PubMed

Insights

Increasing antimicrobial resistance in Streptococcus pneumoniae poses a clinical challenge. This review examines factors, outcomes, and strategies to manage macrolide-resistant pneumococci infections effectively.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Streptococcus pneumoniae is a leading cause of community-acquired respiratory infections.
  • In vitro data show increasing resistance of S. pneumoniae to macrolide antibiotics.
  • The clinical significance of this macrolide resistance remains under-evaluated.

Purpose of the Study:

  • To review risk factors for selecting resistant pneumococci.
  • To discuss clinical outcome assessment endpoints for antimicrobial resistance.
  • To propose strategies for minimizing the impact of S. pneumoniae resistance.

Main Methods:

  • Literature review of risk factors for resistant pneumococci selection.
  • Analysis of clinical outcome assessment endpoints.
  • Review of evidence for treatment failures caused by macrolide-resistant S. pneumoniae.
  • Synthesis of strategies to preserve antibacterial efficacy.

Main Results:

  • In vitro resistance of S. pneumoniae to macrolides is rising.
  • Clinical relevance of this resistance requires further clarification.
  • Treatment failures linked to macrolide-resistant S. pneumoniae have been documented.
  • Risk factors for selecting resistant strains are identifiable.

Conclusions:

  • Rising S. pneumoniae resistance presents significant clinical challenges.
  • Careful selection of antimicrobial agents is crucial to maintain treatment efficacy.
  • Prioritizing antibiotics with a low propensity for resistance development is recommended.
  • Strategies to minimize the impact of resistance are necessary for effective patient management.

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