Journal of Antimicrobial Chemotherapy (2002) 49, 433-436
© 2002 The British Society for Antimicrobial Chemotherapy
Leading article |
The in vivo–in vitro paradox in pneumococcal respiratory tract infections
Department of Medicine, Division of Infectious Diseases, Center for Tuberculosis Research, Johns Hopkins School of Medicine, 424 N. Bond Street, Baltimore, MD 21231-1001, USA
Streptococcus pneumoniae is the most commonly identified cause of community-acquired pneumonia, accounting for 9–55% of cases among patients requiring hospitalization.1 Although resistance to penicillin and other antimicrobial agents among S. pneumoniae was initially recognized in 1967,2 the prevalence of drug-resistant S. pneumoniae (DRSP) remained low until the early 1990s, when penicillin resistance began to increase at an alarming rate. Current estimates indicate that c. 18% of S. pneumoniae strains from the US have intermediate penicillin resistance (MIC 0.12–1.0 mg/L) and 33% have high-level resistance (MIC 
2 mg/L).3,4 Some estimates have placed the increase in high-level penicillin resistance among S. pneumoniae at 60-fold over the past 5–7 years.5,6 Outside the US, resistance to penicillin is even higher, with Spain, Hungary and South Africa reporting rates of intermediate and high-level resistance between 40 and 70%.7–9 Nevertheless, the clinical relevance of antimicrobial resistance in pneumococcal respiratory tract infections remains surprisingly uncertain.
The
Acknowledgements
Notes
References
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L.-H. Su, T.-L. Wu, A.-J. Kuo, J.-H. Chia, and C.-H. Chiu Antimicrobial susceptibility of Streptococcus pneumoniae at a university hospital in Taiwan, 2000-07: impact of modified non-meningeal penicillin breakpoints in CLSI M100-S18 J. Antimicrob. Chemother., August 1, 2009; 64(2): 336 - 342. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. A Cardoso, C. M Nascimento-Carvalho, F. Ferrero, E. N Berezin, R. Ruvinsky, P. A M Camargos, C. C Sant'Anna, M. C. C Brandileone, M. de Fatima P March, J. Feris-Iglesias, et al. Penicillin-resistant pneumococcus and risk of treatment failure in pneumonia Arch. Dis. Child., March 1, 2008; 93(3): 221 - 225. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-C. C. Brandileone, S. T. Casagrande, M.-L. L. S. Guerra, R. C. Zanella, A.-L. S. S. Andrade, and J.-L. D. Fabio Increase in numbers of {beta}-lactam-resistant invasive Streptococcus pneumoniae in Brazil and the impact of conjugate vaccine coverage. J. Med. Microbiol., May 1, 2006; 55(Pt 5): 567 - 574. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Falco, B. Almirante, Q. Jordano, L. Calonge, O. del Valle, C. Pigrau, A. M. Planes, J. Gavalda, and A. Pahissa Influence of penicillin resistance on outcome in adult patients with invasive pneumococcal pneumonia: is penicillin useful against intermediately resistant strains? J. Antimicrob. Chemother., August 1, 2004; 54(2): 481 - 488. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Capitano, H. M. Mattoes, E. Shore, A. O'Brien, S. Braman, C. Sutherland, and D. P. Nicolau Steady-State Intrapulmonary Concentrations of Moxifloxacin, Levofloxacin, and Azithromycin in Older Adults Chest, March 1, 2004; 125(3): 965 - 973. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-I. Morosini, R. Canton, E. Loza, R. del Campo, F. Almaraz, and F. Baquero Streptococcus pyogenes isolates with characterized macrolide resistance mechanisms in Spain: in vitro activities of telithromycin and cethromycin J. Antimicrob. Chemother., July 1, 2003; 52(1): 50 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. E. Varaldo Antimicrobial resistance and susceptibility testing: an evergreen topic J. Antimicrob. Chemother., July 1, 2002; 50(1): 1 - 4. [Full Text] [PDF]
|
|