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Macrolide resistance in pneumococci-is it relevant?

Allen C Cheng1,2,3, Adam W J Jenney4,3,5

  • 1Infection Prevention and Healthcare Epidemiology Unit, Melbourne, Australia.

Pneumonia (Nathan Qld.)
|July 14, 2017
PubMed

Insights

Increasing macrolide resistance in Streptococcus pneumoniae poses a growing concern for pneumonia treatment. While ß-lactams remain effective, macrolides may not be suitable as sole therapy for severe pneumococcal infections.

Area of Science:

  • Microbiology and Infectious Diseases
  • Pharmacology and Therapeutics

Background:

  • Macrolide antibiotics are frequently prescribed for various infections, notably pneumonia.
  • A significant rise in both high-level and low-level macrolide resistance among Streptococcus pneumoniae strains is observed globally.

Discussion:

  • Macrolide resistance in pneumococci has minimal clinical impact when ß-lactam antibiotics are the primary treatment for moderate to severe pneumonia.
  • However, emerging data indicate potential limitations of macrolides as monotherapy for severe pneumococcal infections.

Key Insights:

  • Global increase in macrolide resistance in Streptococcus pneumoniae.
  • Limited clinical relevance of macrolide resistance when ß-lactams are used for pneumonia.
  • Macrolides may not be reliable for monotherapy in serious pneumococcal infections.

Outlook:

  • Need for ongoing surveillance of macrolide resistance patterns.
  • Re-evaluation of treatment guidelines for severe pneumococcal pneumonia.
  • Exploration of alternative antibiotic strategies to combat resistant strains.
Keywords:
Antibiotic resistanceCommunity-acquired pneumoniaMacrolidesStreptococcus pneumoniae

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