Impact of azithromycin administration for trachoma control on the carriage of antibiotic-resistant Streptococcus pneumoniae


Batt, SL; Charalambous, BM; Solomon, AW; Knirsch, C; Massae, PA; Safari, S; Sam, NE; Everett, D; Mabey, DCW; Gillespie, SH; (2003) Impact of azithromycin administration for trachoma control on the carriage of antibiotic-resistant Streptococcus pneumoniae. Antimicrobial agents and chemotherapy, 47 (9). pp. 2765-2769. ISSN 0066-4804 DOI: 10.1128/AAC.47.9.2765-2769.2003

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Abstract

Community distribution of azithromycin has an important role to play in trachoma control. Previous studies have suggested that this may increase the prevalence of macrolide-resistant Streptococcus pneumoniae. S. pneumoniae was isolated from children under 7 years of age in Rombo District, northern Tanzania, before and 2 and 6 months after community-wide administration of azithromycin. Overall carriage rates were 11, 12, and 7%, respectively. Only one macrolide-resistant isolate carrying the mef gene was obtained 6 months after azithromycin administration. This contrasted with cotrimoxazole and penicillin resistance, both of which were common (cotrimoxazole resistance, 42, 43, and 47%, and penicillin resistance, 21, 17, and 16% at baseline, 2 months, and 6 months, respectively). There was a significant association between cotrimoxazole and penicillin resistance (P < 0.0001, Fisher's exact). These data suggest that in communities where macrolide resistance is rare, azithromycin distribution for trachoma control is unlikely to increase the prevalence of resistant organisms.

Item Type: Article
Keywords: Randomized controlled trial, nasopharyngeal carriage, children, prevalence
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Antimicrobial Resistance Centre (AMR)
Malaria Centre
PubMed ID: 12936971
Web of Science ID: 184988000007
URI: http://researchonline.lshtm.ac.uk/id/eprint/15827

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