Increase in Pneumococcus Macrolide Resistance, USA

摘要: To the Editor: Jenkins and Farrell reported an increase in proportion of macrolide-resistant Streptococcus pneumoniae isolates United States (1). They mentioned increased use inappropriate prescription macrolides as potential explanations for macrolide resistance expressed doubts, stating “which (if any) these factors might explain trends here are not clear.” Although spread antimicrobial drug is a complex issue with many contributing factors, we believe that role should be understated. Several studies Europe have provided evidence relationship between resistance. Macrolide exposure leads to emergence on individual level, countries higher outpatient sales more pneumococci (2). Outpatient has decreased since 1995–1996, especially among children. However, azithromycin children, older patients from 1995–1996 through 2005–2006 (3). In this context, it would surprising after increase, show different characteristics than Europe. A 2001 study showed during 1995–1999 coincided doubling (4), further increases 1999 (3) contributed pneumococci. Decreased led decrease pneumococci. yearly seasonal reduction prescribing Israel was associated drug–resistant caused acute otitis media (5). With introduction expanded-valent pneumococcal conjugate vaccines, there promise drug-resistant disease can reduced. Nevertheless, judicious drugs unnecessary prescriptions, promoted by Get Smart: Know When Antibiotics Work (www.cdc.gov/getsmart) campaign, essential limiting selection