Resistance in respiratory tract pathogens: an international study 1997-1998.

Multiple antibiotic resistance threatens current treatment for community-acquired pneumonia (CAP). This paper presents a summary of resistance data for Streptococcus pneumoniae (6,223 isolates), Haemophilus influenzae (4,016) and Moraxella catarrhalis (1,263) collected from 153 centers throughout Japan, China, UK, Germany, Spain, France, Italy, Brazil and USA. Antiobiotics tested were: beta-lactams (penicillin, ampicillin, co-amoxiclav, cefuroxime, and ceftriaxone), macrolides (azithromycin and clarithromycin), sulphonamide (trimethoprim-sulfamethoxazole), glycopeptide (vancomycin) and fluoroquinolone (levofloxacin). S. pneumoniae with reduced susceptibility to penicillin were predominant in France, Spain and Japan (54-65%), ,beta-lactamase-producing H. influenzae most common in the USA, France and Spain (>25%) and most M. catarrhalis produced beta-lactamase irrespective of origin. S. pneumoniae susceptibility to azithromycin and clarithromycin varied widely. Levofloxacin was active against almost all isolates in all countries and none was resistant to vancomycin. Because of increasing resistance to older drugs, the newer fluoroquinolones have a role in the therapy of CAP and other respiratory infections, although surveillance studies must continue.