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Resistance among problem respiratory pathogens in pediatrics

G V Doern1

  • 1Clinical Microbiology Laboratories, University of Massachusetts Medical Center, Worcester 01655, USA.

The Pediatric Infectious Disease Journal
|May 1, 1995
PubMed

Insights

Antimicrobial resistance is increasing in common pediatric pathogens like Streptococcus pneumoniae, limiting treatment options. However, many alternative oral antibiotics remain effective against Haemophilus influenzae and Moraxella catarrhalis.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Beta-lactamase production in Haemophilus influenzae has risen to 35% over two decades.
  • Moraxella catarrhalis isolates predominantly produce beta-lactamase, rendering them resistant to ampicillin and amoxicillin.
  • Increasing penicillin resistance in Streptococcus pneumoniae, due to altered penicillin-binding proteins, poses a significant challenge.

Purpose of the Study:

  • To assess current antimicrobial resistance patterns in key pediatric respiratory pathogens.
  • To evaluate the effectiveness of various oral antibiotics against these resistant strains.
  • To highlight the implications of emerging resistance for clinical treatment strategies.

Main Methods:

  • Review of antimicrobial susceptibility data for clinical isolates of H. influenzae, M. catarrhalis, and S. pneumoniae.
  • Analysis of resistance trends over the past two decades.
  • Evaluation of activity of beta-lactam and non-beta-lactam oral antimicrobials.

Main Results:

  • Amoxicillin/clavulanate, cefuroxime, and cefpodoxime show sustained activity against H. influenzae and M. catarrhalis.
  • Resistance rates to tetracycline, trimethoprim/sulfamethoxazole, and macrolides remain low (1-5%) for H. influenzae.
  • 15-25% of S. pneumoniae isolates exhibit penicillin resistance; third-generation cephalosporins retain activity but emerging resistance is a concern.

Conclusions:

  • While resistance is increasing in S. pneumoniae, alternative oral agents remain viable for H. influenzae and M. catarrhalis infections.
  • Continuous monitoring of antimicrobial resistance patterns is crucial for effective pediatric infectious disease management.
  • Emerging resistance in S. pneumoniae necessitates careful selection of antibiotics and consideration of novel therapeutic strategies.

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