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. 2004 Mar;10(3):514-7.
doi: 10.3201/eid1003.030252.

Antibiotic selection pressure and resistance in Streptococcus pneumoniae and Streptococcus pyogenes

Werner C Albrich  1 , Dominique L Monnet, Stephan Harbarth
Affiliations

Antibiotic selection pressure and resistance in Streptococcus pneumoniae and Streptococcus pyogenes

Werner C Albrich et al. Emerg Infect Dis. 2004 Mar.

Abstract

We correlated outpatient antibiotic use with prevalence of penicillin-nonsusceptible Streptococcus pneumoniae (PNSP), macrolide-resistant S. pneumoniae (MRSP), and macrolide-resistant S. pyogenes (MRGAS) in 20 countries. Total antibiotic use was correlated with PNSP (r = 0.75; p < 0.001), as was macrolide use with MRSP (r = 0.88; p < 0.001) and MRGAS (r = 0.71; p = 0.004). Streptococcal resistance is directly associated with antibiotic selection pressure on a national level.

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Figures

Figure 1
Figure 1
Total antibiotic use in the outpatient setting (vertical axis) versus prevalence of penicillin-nonsusceptible Streptococcus pneumoniae (horizontal axis) in 20 industrialized countries. A regression line was fitted with 95% confidence bands (r = 0.75; p < 0.001).
Figure 2
Figure 2
A. Relationship between macrolide use in the outpatient setting (horizontal axis) and prevalence of macrolide-resistant Streptococcus pneumoniae (vertical axis) in 16 industrialized countries. A regression line was fitted with 95% confidence bands (r = 0.88; p < 0.001). B. Relationship between macrolide use in the outpatient setting (horizontal axis) and prevalence of macrolide-resistant S. pyogenes (vertical axis) in 14 industrialized countries. A regression line was fitted with 95% confidence bands (r = 0.71; p = 0.004).
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