Resistant microorganisms in head and neck infections.
The key pathogens most commonly associated with acute infections in the upper respiratory tract include Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes. Antimicrobial resistance amongst these organisms to many of the commonly used agents for treatment continues to evolve. S. pneumoniae is probably the most important pathogen in the respiratory tract and antimicrobial resistance of this organism to many drugs appears to be rising. For some organisms, such as S. pyogenes, resistance to standard therapy such penicillin has not been described. For others, such as M. catarrhalis, beta-lactamase production has become the norm, with over 90% of isolates now producing this enzyme. One of the major drivers of resistance continues to be the overuse and misuse of antibiotics in the community. This is complicated by the fact that most therapy is empiric and the exact etiology of a patient's infection is not known. Despite the fact that the clinical impact of antibiotic resistance on patient outcomes is not always clear, it remains prudent to consider the issue of resistance when selecting therapy for a patient and to continue to strive for appropriate antibiotic use as a means to stem the tide of evolving resistance.
Mazzulli
Tony
T
Department of Microbiology, Mount Sinai Hospital,Toronto, ON. tmazzulli@mtsinai.on.ca
D004352:Drug Resistance, Microbial; D006192:Haemophilus Infections / Q000188:drug therapy; D006193:Haemophilus influenzae / Q000187:drug effects*; D006801:Humans; D011008:Pneumococcal Infections / Q000188:drug therapy; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000382:microbiology*; D013290:Streptococcal Infections / Q000188:drug therapy; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D013297:Streptococcus pyogenes / Q000187:drug effects*