Antibiotic Resistance in Streptococcus pneumoniae after Azithromycin Distribution for Trachoma

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Trachoma, caused by Chlamydia trachomatis, is a significant global cause of preventable blindness.
• Mass azithromycin (AZM) distribution is a key strategy for trachoma elimination.
• Concerns exist regarding potential development of antibiotic resistance in other bacteria due to widespread AZM use.

Purpose of the Study:

• To review existing literature on pneumococcal prevalence and azithromycin resistance following mass AZM administration for trachoma.
• To assess trends and correlations in antibiotic resistance patterns.

Main Methods:

• Systematic search of Medline and Web of Science databases for studies up to 2013.
• Inclusion of studies measuring pneumococcal prevalence and azithromycin resistance after mass AZM provision.
• Bias assessment using the Cochrane Risk of Bias Tool.

Main Results:

• Eight studies met the inclusion criteria.
• Identified two resistance prevalence trends, influenced by AZM provision frequency and baseline resistance.
• Demonstrated a strong correlation (r = 0.759) between baseline and 2-3 month resistance prevalence.

Conclusions:

• While azithromycin resistance in Chlamydia trachomatis is not reported, resistance in other bacteria is a concern.
• Widespread macrolide antibiotic use for trachoma may compromise treatment efficacy for other infections.
• Long-term trachoma control strategies must consider the broader implications of antibiotic resistance.