Resistance patterns of lower respiratory tract pathogens in Europe.

Resistance to antimicrobial drugs in the major respiratory tract pathogens is known to vary profoundly depending on geographic location. In Europe high rates (>44%) of penicillin-resistance in pneumococci have been recorded in France and Spain, while countries like The Netherlands, the Czech Republic, Austria and Italy are only marginally affected. Similarly, the incidence of macrolide resistance differs widely among European nations with figures ranging from 45.9% (France) to 1.5% (The Netherlands). Significant percentages (>20%) of co-trimoxazole and doxycycline resistance have been found in France, Spain, Italy, Hungary, Poland and Belgium. The prevailing mechanism of resistance in Haemophilus influenzae is represented by beta-lactamase synthesis for which considerable variations (from 0 to 38.5%) have been evidenced. Ampicillin resistant beta-lactamase negative H. influenzae are very uncommon. Over 90% of Moraxella catarrhalis isolates are beta-lactamase producers without big differences among European countries.