title: Connection between trimethoprim-sulfamethoxazole use and resistance in Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
abstract: The association between trimethoprim-sulfamethoxazole use and resistance among the major respiratory tract pathogens was investigated by comparing regional consumption of the drug to regional resistance in the following year in 21 central hospital districts in Finland. A total of 23,530 Streptococcus pneumoniae isolates, 28,320 Haemophilus influenzae isolates, and 14,138 Moraxella catarrhalis isolates were tested for trimethoprim-sulfamethoxazole susceptibility during the study period (1998-2004). Among the S. pneumoniae isolates, a statistically significant connection was found between regional consumption and resistance. No statistically significant connection was found between regional trimethoprim-sulfamethoxazole use and resistance among H. influenzae and M. catarrhalis isolates. According to our results, it seems that only in pneumococci can the development of trimethoprim-sulfamethoxazole resistance be influenced by restricting its use. However, trimethoprim-sulfamethoxazole remains an important antimicrobial agent because of its reasonable price. Hence, resistance to trimethoprim-sulfamethoxazole among these pathogens needs continuous monitoring.
authors.affiliation: Päijät-Häme Social and Health Care Group, Clinical Microbiology, Keskussairaalankatu 7, SF-15850 Lahti, Finland. pauliina.karpanoja@phsotey.fi
authors.forename: Pauliina
authors.initials: P
authors.lastname: Kärpänoja
authors.forename: Solja T
authors.initials: ST
authors.lastname: Nyberg
authors.forename: Miika
authors.initials: M
authors.lastname: Bergman
authors.forename: Tinna
authors.initials: T
authors.lastname: Voipio
authors.forename: Pirkko
authors.initials: P
authors.lastname: Paakkari
authors.forename: Pentti
authors.initials: P
authors.lastname: Huovinen
authors.forename: Hannu
authors.initials: H
authors.lastname: Sarkkinen
mesh_terms: D024881:Drug Resistance, Bacterial; D005387:Finland; D006192:Haemophilus Infections / Q000188:drug therapy / Q000382:microbiology; D006193:Haemophilus influenzae / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D001936:Moraxella catarrhalis / Q000187:drug effects* / Q000302:isolation & purification; D045828:Moraxellaceae Infections / Q000188:drug therapy / Q000382:microbiology; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination