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Journal of Antimicrobial Chemotherapy (1999) 44, 1-6
© 1999 The British Society for Antimicrobial Chemotherapy
Leading article |
Pneumococcal macrolide resistance—myth or reality?
The Clinical Pharmacology Research Center, Research Institute, and the Departments of Pharmacy and Medicine, Bassett Healthcare, Cooperstown, New York, USA
Streptococcus pneumoniae is one of the most common community-acquired respiratory
tract pathogens, causing as many as 
20% of all cases of community-acquired pneumonia
(CAP) annually.
1 Over the years a number of agents have been utilized as
first-line treatment options for this organism. Invariably, as various agents have been used
extensively, in-vitro antimicrobial resistance has developed. Penicillin-resistant pneumococci
(PRP) have become highly prevalent in many countries over the past 10-15 years and are
continuing to spread in many regions of the USA.
2
,3
,4
,5
This (and other) trends in resistance, as well as the recognition of the importance of atypical
pathogens, resulted in CAP outpatient treatment guidelines being released in 1993 that
recommended that the macrolides be utilized as first-line treatment for patients <60 years of
age with no comorbidity.
6 This line of thinking has recently been reinforced by the
Infectious Diseases Society of America with their 1998 CAP treatment guidelines.
7 As a
In-vitro resistance mechanisms
In-vivo data
Pharmacology is the answer
Summary
Acknowledgments
Notes
References
CiteULike 
Connotea 
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