In vitro activities of oral antimicrobial agents against penicillin-resistant Streptococcus pneumoniae: implications for outpatient treatment.

Academic Article

Abstract

  • We tested 83 penicillin-intermediate (Peni) and 50 penicillin-resistant (Penr) isolates of Streptococcus pneumoniae against eight oral antimicrobials. Clarithromycin's MICs (minimal inhibitory concentration) were generally the same or one to two dilutions less than those of azithromycin. Seventy-two percent of Peni isolates were susceptible to clarithromycin and azithromycin, in contrast to 42% and 40%, respectively, of Penr isolates. Cefuroxime activity exceeded that of cefprozil, which exceeded that of cefaclor, in Peni isolates. For all three cephalosporins, MICs of 90% of isolates tested were > or = 3 dilutions higher for Penr isolates than for Peni isolates. Percentages of Peni isolates susceptible to clindamycin and tetracycline were 92% and 83%, respectively, and 78% and 82% for Penr. Only 49% of Peni isolates and 4% of Penr isolates were susceptible to trimethoprim-sulfamethoxazole. Azithromycin, clarithromycin, cefuroxime, cefprozil, clindamycin, and tetracycline may be useful in treating infections caused by Peni S pneumoniae, but Penr isolates are frequently resistant to both old and newer agents.
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    Published In

    Keywords

  • Administration, Oral, Adult, Ambulatory Care, Anti-Bacterial Agents, Azithromycin, Cefaclor, Cefuroxime, Cephalosporins, Child, Clarithromycin, Clindamycin, Culture Media, Humans, Penicillin Resistance, Pneumococcal Infections, Streptococcus pneumoniae, Tetracycline, Trimethoprim, Sulfamethoxazole Drug Combination
  • Author List

  • Waites K; Swiatlo E; Gray B; Brookings E
  • Start Page

  • 621
  • End Page

  • 626
  • Volume

  • 90
  • Issue

  • 6