title: Impact of azithromycin administration for trachoma control on the carriage of antibiotic-resistant Streptococcus pneumoniae.
abstract: Community distribution of azithromycin has an important role to play in trachoma control. Previous studies have suggested that this may increase the prevalence of macrolide-resistant Streptococcus pneumoniae. S. pneumoniae was isolated from children under 7 years of age in Rombo District, northern Tanzania, before and 2 and 6 months after community-wide administration of azithromycin. Overall carriage rates were 11, 12, and 7%, respectively. Only one macrolide-resistant isolate carrying the mef gene was obtained 6 months after azithromycin administration. This contrasted with cotrimoxazole and penicillin resistance, both of which were common (cotrimoxazole resistance, 42, 43, and 47%, and penicillin resistance, 21, 17, and 16% at baseline, 2 months, and 6 months, respectively). There was a significant association between cotrimoxazole and penicillin resistance (P < 0.0001, Fisher's exact). These data suggest that in communities where macrolide resistance is rare, azithromycin distribution for trachoma control is unlikely to increase the prevalence of resistant organisms.
authors.affiliation: Department of Medical Microbiology, University College London, Royal Free Campus, London NW3 2PF.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Batt
authors.forename: Bambos M
authors.initials: BM
authors.lastname: Charalambous
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Solomon
authors.forename: Charles
authors.initials: C
authors.lastname: Knirsch
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Massae
authors.forename: Salesia
authors.initials: S
authors.lastname: Safari
authors.forename: Noel E
authors.initials: NE
authors.lastname: Sam
authors.forename: Dean
authors.initials: D
authors.lastname: Everett
authors.forename: David C W
authors.initials: DC
authors.lastname: Mabey
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Gillespie
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D002353:Carrier State / Q000188:drug therapy* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000382:microbiology*; D011159:Population Surveillance; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D014141:Trachoma / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin