Journal of Antimicrobial Chemotherapy, Vol 42, 729-734, Copyright © 1998 by The British Society for Antimicrobial Chemotherapy
KP Klugman, T Capper, CA Widdowson, HJ Koornhof and W Moser
The susceptibility of 40 erythromycin-resistant isolates of Streptococcus
pyogenes and 40 multiply-resistant isolates of Streptococcus pneumoniae to
six macrolide antibiotics, representing 14- , 15- and 16-membered lactone
ring structures, was tested. The genetic basis for macrolide resistance in
the strains was also determined. Both erm and mef determinants were
encountered in the 36 S. pneumoniae isolates tested, but only mef in the
five S. pyogenes isolates tested. All isolates showed cross-resistance
among the 14-membered macrolides erythromycin, clarithromycin and
roxithromycin and the 15-membered macrolide, azithromycin. However, the
erythromycin-resistant S. pyogenes isolates retained full susceptibility to
spiramycin and josamycin (16-membered agents). These latter two antibiotics
were also more active than the other macrolides against
erythromycin-resistant S. pneumoniae isolates, especially josamycin which
was 8-64 times more active than erythromycin; spiramycin was only two to
eight times more active than erythromycin.
Increased activity of 16-membered lactone ring macrolides against erythromycin-resistant Streptococcus pyogenes and Streptococcus pneumoniae: characterization of South African isolates [In Process Citation]
MRC/SAIMR/WITS Pneumococcal Diseases Research Unit, South African Institute for Medical Research, Johannesburg.
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