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Penicillin-resistant pneumococcus and risk of treatment failure in pneumonia

Maria Regina A Cardoso1, Cristiana M Nascimento-Carvalho, Fernando Ferrero

  • 1Faculdade de Saúde Pública, Universidade de São Paulo, Brazil. rcardoso@usp.br

Archives of Disease in Childhood
|September 13, 2007
PubMed

Insights

Penicillin-resistant Streptococcus pneumoniae did not increase treatment failure in children with severe pneumonia. Intravenous penicillin/ampicillin is effective for penicillin-resistant pneumococcal pneumonia when MIC is below 2 microg/ml.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Resistance
  • Pneumonia Treatment

Background:

  • Severe pneumonia in children is a significant global health concern.
  • The emergence of antibiotic resistance, particularly penicillin resistance in Streptococcus pneumoniae, poses a challenge to effective treatment.
  • Understanding the clinical impact of resistant strains is crucial for guiding therapeutic strategies.

Purpose of the Study:

  • To investigate if in vitro penicillin-resistant Streptococcus pneumoniae increases the risk of clinical failure in children hospitalized with severe pneumonia.
  • To evaluate the efficacy of intravenous penicillin/ampicillin treatment in the presence of penicillin-resistant pneumococcal strains.

Main Methods:

  • A multicenter, prospective, observational study was conducted across 12 tertiary-care centers in Latin America.
  • 240 children (3-59 months) with severe pneumonia were enrolled, and their Streptococcus pneumoniae susceptibility to penicillin was determined using minimal inhibitory concentration (MIC) testing.
  • Patients received intravenous penicillin/ampicillin, and treatment failure was assessed using clinical criteria.

Main Results:

  • The overall treatment failure rate was 21%.
  • After adjusting for potential confounders, no significant association was found between treatment failure and in vitro penicillin resistance of Streptococcus pneumoniae (adjusted RR = 1.03; 95% CI: 0.49-1.90).

Conclusions:

  • Intravenous penicillin/ampicillin remains a recommended treatment for penicillin-resistant pneumococcal pneumonia.
  • This treatment is effective in regions where the penicillin MIC for Streptococcus pneumoniae does not exceed 2 microg/ml.
Abstract

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