title: Susceptibility of group A beta-hemolytic streptococci to thirteen antibiotics: examination of 301 strains isolated in the United States between 1994 and 1997.
abstract: BACKGROUND
  Because of continuing reports from many countries of increasing resistance of group A streptococci to macrolide antibiotics, we determined the antibiotic susceptibility of recent group A streptococcal isolates from the United States.
  
  
  METHODS
  We evaluated 301 Streptococcus pyogenes isolates (245 from patients with uncomplicated pharyngitis and 56 isolates from patients with invasive systemic infections) for susceptibility using the Etest technique. The isolates came from 24 states and the District of Columbia during the years 1994 through 1997. Thirteen antibiotics (azithromycin, ceftriaxone, cephalothin, chloramphenicol, ciprofloxacin, clindamycin, erythromycin, imipenem, levofloxacin, oxacillin, penicillin G, tetracycline and trimethoprim-sulfamethoxazole) were studied.
  
  
  RESULTS
  The MIC90 for penicillin was 0.016 microg/ml, which is not significantly different from previous reports. Of the 301 isolates only 2.6% were resistant to a macrolide antibiotic and only 4% were resistant to tetracycline.
  
  
  CONCLUSIONS
  These data indicate that antibiotic resistance among recent isolates of group A streptococci (including those from patients with severe infections) currently is not a clinically significant problem in the United States.
authors.affiliation: Department of Pediatrics, World Health Organization Collaborating Center, for Reference and Research on Streptococci, University of Minnesota Medical School, Minneapolis, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Kaplan
authors.forename: D R
authors.initials: DR
authors.lastname: Johnson
authors.forename: M C
authors.initials: MC
authors.lastname: Del Rosario
authors.forename: D L
authors.initials: DL
authors.lastname: Horn
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D006801:Humans; D008826:Microbial Sensitivity Tests; D012703:Serotyping; D013290:Streptococcal Infections / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000145:classification / Q000187:drug effects*; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents