Journal Article

Microbiological and Pharmacodynamic Considerations in the Treatment of Infection Due to Antimicrobial-Resistant <i>Streptococcus pneumoniae</i>

Peter C. Appelbaum

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue Supplement_2, pages S29-S34
Published in print August 2000 | ISSN: 1058-4838
Published online August 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/314057
Microbiological and Pharmacodynamic Considerations in the Treatment of Infection Due to Antimicrobial-Resistant Streptococcus pneumoniae

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The incidence of antimicrobial-resistant strains of Streptococcus pneumoniae has increased alarmingly in recent years. The problem is exacerbated by the global spread of resistant organisms. Currently, the incidence of penicillin-resistant pneumococci isolated from clinical specimens in the United States is ⩾35%. For empirical oral treatment of community-acquired respiratory infections, 3 choices are available: β-lactam agents, macrolides, and fluoroquinolones. In considering the therapeutic efficacy of these agents, it is essential to also take pharmacokinetic and pharmacodynamic (PK/PD) factors into account. Many drugs are effective against penicillin-susceptible strains. However, the higher the minimum inhibitory concentration of penicillin, the more likely that cross-resistance to β-lactam agents and macrolides will occur. Currently, the incidence of fluoroquinolone-resistant pneumococci is low; it is proposed that adequate dosing based on the PK/PD properties of fluoroquinolones may help reduce the emergence of resistant organisms. Prudent use of all antimicrobials is essential to decrease the emergence of strains resistant to these agents.

Journal Article.  4585 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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