PMID: 8937844Aug 1, 1996Paper

Defining resistance: breakpoints and beyond implications for pediatric respiratory infection

Diagnostic Microbiology and Infectious Disease
S Pelton

Abstract

The emergence of isolates of Streptococcus pneumoniae with reduced susceptibility to penicillins, cephalosporins, trimethoprim-sulfamethoxazole, and macrolide antibiotics requires a re-evaluation of strategies for the treatment of community-acquired respiratory disease. One response has been the consideration of withholding initial antimicrobial therapy for children with acute otitis media (AOM). Review of clinical studies supports a reduction in suppurative complications, and a more rapid resolution of signs and symptoms as well as the course of middle ear disease in children treated with antimicrobial agents. Breakpoints established by the NCCLS for in vitro susceptibility reporting may not reflect clinical efficacy at all sites of disease. Clinical studies of AOM due to penicillin-resistant S. pneumoniae report success with both cefuroxime and amoxicillin-clavulanic acid, however, microbiologic studies suggest an increase in persistent infection in children with disease due to isolates with reduced susceptibility. Successful therapy for AOM due to highly resistant isolates (MIC > or = 2.0 micrograms/ml for penicillin) has been reported with clindamycin, ceftriaxone, and high-dose amoxicillin. The current risk of AOM due to a...Continue Reading

Related Concepts

Related Feeds

Bacterial Pneumonia

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

Antimicrobial Resistance (ASM)

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.

Bacterial Pneumonia (ASM)

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antimicrobial Resistance

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.