title: Clinical and public health implications of macrolide-resistant Streptococcus pneumoniae.
abstract: Macrolide resistance among Streptococcus pneumoniae is a growing global concern, although its specific impact on public health is not currently well defined. A Consensus Working Group was convened in March 2001 to address whether credible, scientific data substantiate macrolide resistance in S. pneumoniae as: (i) producing significant morbidity; (ii) creating attendant health and economic burdens; (iii) constituting a public health threat; and (iv) warranting intervention, including development of new antibiotics with efficacy against these strains. Despite the limitations of available clinical data, concern about the possibility of treatment failure with macrolides is being expressed in clinical practice and in formal treatment guidelines, threatening the important role of these agents in the treatment of respiratory tract infections. Further studies are required to monitor and control macrolide resistance and evaluate settings in which macrolide treatment failures are occurring, and new therapeutic interventions are needed.
authors.affiliation: Beth Israel Deaconess Medical Center, Department of Medicine, Boston, MA 02215, USA. Rmoeller@caregroup.harvard.edu
authors.forename: R C
authors.initials: RC
authors.lastname: Moellering
authors.forename: William
authors.initials: W
authors.lastname: Craig
authors.forename: Michael
authors.initials: M
authors.lastname: Edmond
authors.forename: David J
authors.initials: DJ
authors.lastname: Farrell
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Ferraro
authors.forename: Thomas M
authors.initials: TM
authors.lastname: File
authors.forename: Jerome
authors.initials: J
authors.lastname: Klein
authors.forename: John
authors.initials: J
authors.lastname: Lonks
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Metlay
authors.forename: Daniel
authors.initials: D
authors.lastname: Sahm
authors.forename: George H
authors.initials: GH
authors.lastname: Talbot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001208:Asia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D018942:Macrolides; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D011634:Public Health / Q000191:economics / Q000639:trends; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides