Influence of macrolide antibiotics on promotion of resistance in the oral flora of children.

摘要: Background: The long elimination half-life of azithromycin allows subinhibitory serum and epithelial lining fluid (ELF) concentrations over a period several weeks post treatment, which may have an impact on the emergence macrolide resistance. In this prospective, open-label, randomized study, four macrolides azalide were studied for their likelihood to promote resistance in oral flora children with respiratory tract infections. Patients Methods: Children randomly assigned receive azithromycin, clarithromycin, erythromycin, roxithromycin josamycin. Throat swabs obtained prior treatment weekly 6 weeks. Minimum inhibitory (MICs) resistant strains assessed by E-test National Committee Clinical Laboratory Standards (NCCLS) broth microdilution. Results: One week up 90% harbored macrolide-resistant flora. Except percentage patients colonized organisms decreased rate 17% clarithromycin (10/60), erythromycin (2/12) josamycin 33% (4/12) after group, 85% (51/60) weeks, 11.6% (7/60) chiildren suffered from reinfection. Conclusion: Azithromycin therapy appears put selective pressure infective native children, promoting carriage marcolide-resistant strains.