Antibiotic-resistant Streptococcus pneumoniae - Implications for medical practice

E. E.L. Wang, Sandra Arnold, J. D. Kellner

Research output: Contribution to journalReview article

Abstract

Objective: To review the definition and prevalence of antibiotic- resistant Streptococcus pneumoniae, its links with antibiotic prescribing, data on antibiotic prescribing and prescribing appropriateness, and evidence- based treatment guidelines for common respiratory tract syndromes. Quality of evidence: Primary studies consist of cross-sectional surveys and case- control studies. Treatment guidelines are based on clinical trials, meta- analyses, and cohort studies. Study designs were appropriate for the specific study questions. Main findings: The increasing prevalence of penicillin- resistant S pneumoniae is concurrent with increasing antibiotic prescribing. Individual patients show a twofold to nine-fold increase in nasopharyngeal carriage of resistant bacteria or invasion with resistant bacteria (among those who have received antibiotics in the preceding 3 months). Cross- sectional data as well as data from medicaid and drug databases attest to overprescribing of antibiotics for respiratory tract infections. Physician surveys and focus groups blame this on parental pressure for antibiotic prescriptions. However, parents in focus groups and surveys deny they pressure their physicians and indicate their main purpose for office visits is to obtain a diagnosis and to seek reassurance that their children are not seriously ill. Evidence-based guidelines suggest treatment strategies that would reduce antibiotic prescribing. Conclusions: The few antibiotics that can be used with resistant organisms are expensive and are increasingly being needed. To control the rise of antibiotic resistance, it is important to limit antibiotic overprescribing.

Original languageEnglish (US)
Pages (from-to)159-170
Number of pages12
JournalHong Kong Practitioner
Volume21
Issue number4
StatePublished - Jan 1 1999

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Streptococcus pneumoniae
Anti-Bacterial Agents
Guidelines
Focus Groups
Pharmaceutical Databases
Bacteria
Physicians
Pressure
Office Visits
Medicaid
Microbial Drug Resistance
Respiratory Tract Infections
Penicillins
Respiratory System
Prescriptions
Meta-Analysis
Case-Control Studies
Pneumonia
Cohort Studies
Therapeutics

All Science Journal Classification (ASJC) codes

  • Family Practice

Cite this

Antibiotic-resistant Streptococcus pneumoniae - Implications for medical practice. / Wang, E. E.L.; Arnold, Sandra; Kellner, J. D.

In: Hong Kong Practitioner, Vol. 21, No. 4, 01.01.1999, p. 159-170.

Research output: Contribution to journalReview article

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