Clinical and public health implications of macrolide-resistant Streptococcus pneumoniae
Infectious Diseases; Pathology; united-states; Pharmacology & Pharmacy; in-vitro; Oncology; community-acquired pneumonia; macrolide resistance; streptococci; respiratory; pneumoniae; haemophilus-influenzae; moraxella-catarrhalis; tract infections; macrolides; otitis-media; group-a; erythromycin resistance; decreased susceptibility; initial antimicrobial therapy; pneumococcal resistance; S.; treatment failure
Macrolide resistance among Streptococcus pneumoniae is a growing global concern, although its specific impact on public health is not currently well defined. A Consensus Working Group was convened in March 2001 to address whether credible, scientific data substantiate macrolide resistance in S. pneumoniae as: (i) producing significant morbidity; (ii) creating attendant health and economic burdens; (iii) constituting a public health threat; and (iv) warranting intervention, including development of new antibiotics with efficacy against these strains. Despite the limitations of available clinical data, concern about the possibility of treatment failure with macrolides is being expressed in clinical practice and in formal treatment guidelines, threatening the important role of these agents in the treatment of respiratory tract infections. Further studies are required to monitor and control macrolide resistance and evaluate settings in which macrolide treatment failures are occurring, and new therapeutic interventions are needed.
Moellering R C; Consensus Working Grp
Journal of Chemotherapy
2002
2002-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1080/1120009x.2002.11782351" target="_blank" rel="noreferrer noopener">10.1080/1120009x.2002.11782351</a>
Managing patients with recurrent acute exacerbations of chronic bronchitis: a common clinical problem
acute exacerbation; acute otitis media; airway inflammation; antimicrobial resistance; chronic bronchitis; chronic obstructive; community-acquired pneumonia; disease; empiric therapy; General & Internal Medicine; haemophilus-influenzae; moraxella-catarrhalis; obstructive-pulmonary-disease; pneumococcal; pneumonia; pulmonary; Research & Experimental Medicine; resistance; resistant streptococcus-pneumoniae; surveillance program
Chronic obstructive pulmonary disease (COPD) affects 15 million people and is the fourth leading cause of death in the United States. It places a considerable burden on the healthcare system, with exacerbations contributing to a significant proportion of this burden. Patients with recurrent exacerbation, who experience more than 2 exacerbations per year, are especially difficult to manage. Several potential host, pathogen, and treatment factors can be identified that contribute to recurrent exacerbation. Patients with recurrent exacerbations are often exposed to frequent courses of antimicrobials. Therefore, antimicrobial resistance among common bacterial pathogens is likely to be prevalent in this group of patients, and further complicates therapy in this already difficult-to-treat patient population. In the management of patients with recurrent exacerbation, one goal should be to decrease the frequency of exacerbations, for which several strategies are suggested. In this article, we will review available literature identified through an extensive search of Medline and PubMed on the characteristics and approach to management of these difficult-to-treat patients. There is a substantial need for more research to understand the etiology and identify efficacious interventions to reduce the frequency of exacerbations of COPD.
Sethi S; File T M
Current Medical Research and Opinion
2004
2004-10
Journal Article
<a href="http://doi.org/10.1185/030079904x3096" target="_blank" rel="noreferrer noopener">10.1185/030079904x3096</a>