Erythromycin resistance in neonatal staphylococcal infection: a long-term survey

Twenty years ago staphylococcal infection was a major problem among newborn infants in hospitals. Hygienic measures had not proved very effective and the use of antibiotics, although clearly open to question, seemed a possible method of control. Erythromycin, a new antibiotic effective against staphylococci, had just been introduced but reports from the United States suggested that resistance could occur within months of usage. In trials in two hospitals in which erythromycin was not being used elsewhere, erythromycin resistance developed but took years to do so. The longer the period of usage was extended the greater the resistance. Withdrawal of the drug resulted ultimately in the disappearance of resistance. The resistant staphylococci spread throughout the hospital. The staphylococcal infection rate in the units where erythromycin was used did not fall but the mortality rate from staphylococcal infection did.