Journal Article

Trends of penicillin and erythromycin resistance among invasive <i>Streptococcus pneumoniae</i> in Europe

Nienke Bruinsma, Karl G. Kristinsson, Stef Bronzwaer, Paul Schrijnemakers, John Degener, Edine Tiemersma, Waleria Hryniewicz, Jos Monen and Hajo Grundmann

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 54, issue 6, pages 1045-1050
Published in print December 2004 | ISSN: 0305-7453
Published online December 2004 | e-ISSN: 1460-2091 | DOI:
Trends of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae in Europe

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  • Medical Oncology
  • Critical Care


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Objectives: To forecast trends in resistance to penicillin and erythromycin among Streptococcus pneumoniae in Europe.

Methods: Since 1999, the European Antimicrobial Resistance Surveillance System (EARSS) has collected routine antimicrobial susceptibility test results of S. pneumoniae. To observe and predict changes of reduced susceptibility over time, we used a multinomial logistic regression model.

Results: Large variations in penicillin and erythromycin non-susceptibility were observed between countries, and reduced susceptibility to erythromycin (17%) has become more frequent than reduced susceptibility to penicillin (10%) in Europe overall. An overall decrease in single penicillin non-susceptibility, but an increase in dual non-susceptibility was observed, indicating a shift of single penicillin to combined non-susceptibility with erythromycin. By 2006, the proportion of single erythromycin and dual non-susceptibility could increase to as much as 20.4% and 8.9%, respectively.

Conclusions: Our results indicate that appropriately dosed β-lactams for empirical therapy are still the treatment of choice, and that macrolides should be used with prudence.

Keywords: public health; antimicrobial resistance; antimicrobial use

Journal Article.  3489 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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