title: Eradication of nasopharyngeal carriage of penicillin-non-susceptible Streptococcus pneumoniae--is it possible?
abstract: BACKGROUND
  The South Swedish Pneumococcal Intervention Project (SSPIP) was started in 1995 with the aim of limiting the spread of penicillin-non-susceptible pneumococci (PNSP) in Skåne County, Sweden. As part of the SSPIP, eradication therapy with rifampicin in combination with 1 more antibiotic was considered on a social indication after prolonged carriage of 2-3 months.
  
  
  METHODS
  In this retrospective study, 125 medical records were analyzed. Children aged 0-10 y referred for eradication therapy in Malmö and Lund, due to a prolonged nasopharyngeal carriage of PNSP with a penicillin G minimum inhibitory concentration of ≥ 0.5 mg/l, between the y 1997 and 2011 were included. Two consecutive negative cultures, with the second one no shorter than 7 days after treatment completion, were required for the carriage to be considered eradicated.
  
  
  RESULTS
  Out of 125 children, 71 received treatment with rifampicin in combination with amoxicillin (n = 44), erythromycin (n = 22), or clindamycin (n = 5) for 7 days. Eradication treatment was successful in 91.5% of the children. Six children (8.5%) had treatment failure with amoxicillin and rifampicin; 3 were found by late follow-up. There was a trend towards a better outcome with erythromycin and clindamycin combinations in comparison to amoxicillin.
  
  
  CONCLUSIONS
  Eradication therapy was successful, but a proper follow-up is essential.
authors.affiliation: Infectious Diseases Unit, Department of Clinical Sciences, Malmö, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Hellberg
authors.forename: Sandra
authors.initials: S
authors.lastname: Johansson
authors.forename: Inga
authors.initials: I
authors.lastname: Odenholt
authors.forename: Torsten
authors.initials: T
authors.lastname: Holmdahl
authors.forename: Håkan
authors.initials: H
authors.lastname: Ringberg
authors.forename: Wimar Percy
authors.initials: WP
authors.lastname: Nilsson
authors.forename: Hans
authors.initials: H
authors.lastname: Norrgren
authors.forename: Jonas
authors.initials: J
authors.lastname: Ahl
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002353:Carrier State / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D010400:Penicillin G / Q000494:pharmacology; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000382:microbiology*; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification*; D013548:Sweden
chemical_list: D000900:Anti-Bacterial Agents; D010400:Penicillin G