Penicillin-resistant pneumococci.
Penicillin-resistant pneumococci are of concern in respiratory tract infections. Currently, nearly all of the "penicillin resistance" to Streptococcus pneumoniae is relative resistance which indicates decreased antibiotic activity in terms of the MIC, but these isolates are still susceptible to sensitive antibiotics given in the usual/high doses. The emergence of highly resistant Streptococcus pneumoniae may be minimized by preferentially using antibiotics known to have a high degree of antipneumococcal activity with a low resistance potential, e.g., doxycycline, cefprozil, levofloxacin, cefepime or meropenem. While vancomycin is useful to treat highly resistant strains, its use should be decreased to minimize the emergence of VRE and strains of Staphylococcus aureus with intermediate vancomycin sensitivity.
Cunha
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BA
Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.