Trimethoprim-sulfamethoxazole prophylaxis and antibiotic nonsusceptibility in invasive pneumococcal disease.
Among 5,043 invasive pneumococcal disease (IPD) isolates identified through South African national surveillance from 2003 to 2007, we estimated the effect of trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis on antimicrobial resistance. Patients on TMP-SMX prophylaxis were more likely to have a pneumococcal isolate nonsusceptible to TMP-SMX, penicillin, and rifampin. TMP-SMX nonsusceptibility was associated with nonsusceptibility to penicillin, erythromycin, and rifampin and multidrug resistance. This study informs empirical treatment of suspected IPD in patients with a history of TMP-SMX use.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA. hsoeters@email.unc.edu
Heidi M
HM
Soeters
Anne
A
von Gottberg
Cheryl
C
Cohen
Vanessa
V
Quan
Keith P
KP
Klugman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D004917:Erythromycin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D011159:Population Surveillance; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use; D013019:South Africa / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification / Q000502:physiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D010406:Penicillins; D004917:Erythromycin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D012293:Rifampin