title: Change in pneumococcal susceptibility to azithromycin during treatment for acute otitis media.
abstract: Authorities have suggested restriction of azithromycin use as a principal strategy to contain the spread of azithromycin-nonsusceptible Streptococcus pneumoniae (ANSP). In 83 children persistently colonized by pneumococcus during and after treatment of acute otitis media, 17 acquired a new strain, 9 of which were less susceptible to azithromycin than the original isolate. New appearance of ANSP was documented after both beta-lactam and azithromycin exposure. ANSP is likely to disseminate even with significant reduction of azithromycin use unless other antibiotic use is decreased as well.
authors.affiliation: Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. pxt2@case.edu
authors.forename: Philip
authors.initials: P
authors.lastname: Toltzis
authors.forename: Michael
authors.initials: M
authors.lastname: Dul
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Blumer
mesh_terms: D017963:Azithromycin / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests; D010033:Otitis Media / Q000188:drug therapy* / Q000382:microbiology; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects*
chemical_list: D010406:Penicillins; D017963:Azithromycin