Antimicrobial-resistant Streptococcus pneumoniae: trends and management

Abstract

Management of pneumococcal infections has been challenged by the development of resistance and, more recently, the unexpected spread of resistant clones of serotypes, such as 19A, following the introduction of a conjugate pneumococcal vaccine for use in children in 2000. High-dose penicillin G and many other agents continue to be efficacious parenterally for pneumonia and bacteremia. However, treatment options for meningitis and for infections treated with oral agents, particularly in children, have been limited by resistance. Empiric treatment guidelines should reflect the emerging threats from increased drug resistance. Compliance with guidelines by physicians and patients is important to prevent further development of resistance as new classes of agents are unlikely to be available in the next decade.

Keywords::

• antimicrobial agent
• antimicrobial resistance
• antimicrobial therapy
• meningitis
• pneumococcal conjugate vaccine
• respiratory tract infection
• Streptococcus pneumoniae

Financial & competing interests disclosure

Research grants: Abbott Pharmaceuticals, ARPIDA Pharmaceuticals, Aventis Pharmaceuticals, Basilea Pharmaceuticals, Bristol-Myers Squibb Pharmaceuticals, Bayer Pharmaceuticals, Daiichi Pharmaceuticals, Dr Reddy’s Laboratory, Eli Lilly & Co, GlaxoSmithKline Pharmaceuticals, Meiji Pharmaceuticals, Ortho–McNeil Pharmaceutical, Pfizer Inc, Rambaxy Laboratories, Roche Pharmaceuticals, TAP Pharmaceuticals, Warner-Lambert Pharmaceuticals, Wockhardt Pharmaceuticals and Wyeth Ayerst/Lederle Pharmaceuticals.

Consultation: Abbott Pharmaceuticals, Aventis Pharmaceuticals, Bristol-Myers Squibb Pharmaceuticals, Bayer Pharmaceuticals, GeneSoft Pharmaceuticals, Lupin Pharmaceuticals, Ortho-McNeil Pharmaceutical, Sano-Aventis Pharmaceuticals, TAP Pharmaceuticals, Wockhardt Pharmaceuticals and Wyeth Ayerst/Lederle Pharmaceuticals.

Speakers Bureau: Bayer Pharmaceuticals, GlaxoSmithKline Pharmaceuticals and Ortho-McNeil Pharmaceutical.

The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.