1887

Abstract

Summary

The susceptibility of 180 clinical isolates of from six regions of The Netherlands to the macrolide antibiotics azithromycin, clarithromycin, erythromycin and roxithromycin was analysed. The results of a microbroth MIC method, the E-test method and a disk diffusion assay were compared, and the MBC determined. In addition, the susceptibility to erythromycin of 436 clinical isolates of from the Leiden region was determined. The microbroth MIC90s of azithromycin, clarithromycin, erythromycin and roxithromycin for group A streptococci were ≤ 0.5 mg/L. Erythromycin had the lowest MIC90 (0.09mg/L). The MIC data obtained with the E-test method suggested that clarithromycin and erythromycin had slightly higher anti-streptococcal activity than azithromycin and roxithromycin MICs obtained with the E-test were lower than those found with the microbroth method. Only minor discrepancies were observed among the three methods. The MBC50 for both clarithromycin and erythromycin was 0.75 mg/L and 5.0mg/L for azithromycin and roxithromycin. None of the 180 strains and two of the collection of 436 strains (0.5%) were resistant to erythromycin and the other macrolides tested; MICs ranged from 1 to 16 mg/L. The erythromycin-resistant strains showed an inducible type of macrolide-lincosamide-streptogramin B (MLS) resistance.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/00222615-43-5-386
1995-11-01
2024-12-05
Loading full text...

Full text loading...

/deliver/fulltext/jmm/43/5/medmicro-43-5-386.html?itemId=/content/journal/jmm/10.1099/00222615-43-5-386&mimeType=html&fmt=ahah

References

  1. Kaufhold A., Podbielski A., Kühnemund O., Lütticken R. Infektionen durch Streptococcus pyogenes: Neuere aspekte zur diagnostik, epidemiologie, klinik und therapie. Immun Infekt 1992; 20:192–199
    [Google Scholar]
  2. Kaplan E. L., Johnson D. R., Cleary P. P. Group A streptococcal serotypes isolated from patients and sibling contacts during the resurgence of rheumatic fever in the United States in the mid-1980s. J Infect Dis 1989; 159:101–103
    [Google Scholar]
  3. Denny F. W. Group A streptococcal infections—1993. Curr Probl Pediatr 1993; 23:179–185
    [Google Scholar]
  4. Bisno A. L. Group A streptococcal infections and acute rheumatic fever. N Engl J Med 1991; 325:783–793
    [Google Scholar]
  5. Peter G. Streptococcal pharyngitis: current therapy and criteria for evaluation and new agents. Clin Infect Dis 1992; 14: Suppl 2S218–223
    [Google Scholar]
  6. Vukmir R. B. Adult and pediatric pharyngitis: a review. J Emerg Med 1992; 10:607–616
    [Google Scholar]
  7. Roos K., Holm S. E., Ekedahl C. Treatment failure in acute streptococcal tonsillitis in children over the age of 10 and in adults. Scand J Infect Dis 1985; 17:357–365
    [Google Scholar]
  8. Tuomanen E., Durack D. T., Tomasz A. Antibiotic tolerance among clinical isolates of bacteria. Antimicrob Agents Chemother 1986; 30:521–527
    [Google Scholar]
  9. Dagan R., Feme M. Association of penicillin-tolerant streptococci with epidemics of streptococcal pharyngitis in closed communities. Eur J Clin Microbiol Infect Dis 1989; 8:629–631
    [Google Scholar]
  10. Brook I. The role of ß-lactamase-produeing bacteria in the persistence of streptococcal tonsillar infection. Rev Infect Dis 1984; 6:601–607
    [Google Scholar]
  11. Brook I. Penicillin failure and copathogenicity in streptococcal pharyngotonsillitis. J Fam Pract 1994; 38:175–179
    [Google Scholar]
  12. Kirst H. A., Sides G. D. New directions for macrolide antibiotics: structural modifications and in vitro activity. Antimicrob Agents Chemother 1989; 33:1413–1418
    [Google Scholar]
  13. Bahai N., Nahata M. C. The new macrolide antibiotics: azithromycin, clarithromycin, dirithromycin, and roxithromycin. Ann Pharmacouther 1992; 26:46–55
    [Google Scholar]
  14. Rodvold K. A., Piscitelli S. C. New oral macrolide and fluoroquinolone antibiotics: An overview of pharmacokinetics, interactions, and safety. Clin Infect Dis 1993; 17: Suppl 1S192–199
    [Google Scholar]
  15. Hamilton-Miller J. M. T. In-vitro activities of 14-, 15- and 16-membered macrolides against Gram-positive cocci. J Antimicrob Chemother 1992; 29:141–147
    [Google Scholar]
  16. Maruyama S., Yoshioka H., Fujita K., Takimoto M., Satake Y. Sensitivity of group A streptococci to antibiotics. Prevalence of resistance to erythromycin in Japan. Am J Dis Child 1979; 133:1143–1145
    [Google Scholar]
  17. Seppälä H., Nissinen A., Yu Q., Huovinen P. Three different phenotypes of erythromycin-resistant Streptococcus pyogenes in Finland. J Antimicrob Chemother 1993; 32:885–891
    [Google Scholar]
  18. National Committee for Clinical Laboratory Standards Performance standards for antimicrobial susceptibility testing; fourth informational supplement M100–S4. NCCLS; Villanova. PA: 1992
    [Google Scholar]
  19. Foulds G., Johnson R. B. Selection of dose regimens of azithromycin. J Antimicrob Chemother 1993; 31: Suppl E 39–50
    [Google Scholar]
  20. Phillips I., Acar J., Baquero F., Bergan T., Forsgren A., Wiedemenn B. ESGAB breakpoint determination: clarithromycin. Eur J Clin Microbiol Infect Dis 1991; 10:993–994
    [Google Scholar]
  21. Mouton R. P., Van Klingeren B. (eds) Standaardisatie vangevoeligheidsbepalingen Rijksinstituut voor de Volksgezondheid en Milieuhygiene (RIVM); Bilthoven, The Netherlands: 1985
    [Google Scholar]
  22. De Neeling A. J., Hemmes J. H., Van Klingeren B. (eds) Resistentietegen antibiotica bij routine-isolaten van bacterien in zeven streeklaboratoria. Rapportnummer 25360-1001 Rijksinstituut voor de Volksgezondheid en Milieuhygiene (RIVM); Bilthoven, The Netherlands: 1993
    [Google Scholar]
  23. Eady E. A., Ross J. I., Cove J. H. Multiple mechanisms of erythromycin resistance. J Antimicrob Chemother 1990; 26:461–465
    [Google Scholar]
  24. Fernandes P. B., Baker W. R., Freiberg L. A., Hardy D. J., McDonald E. J. New macrolides active against Streptococcus pyogenes with inducible or constitutive type of macrolide-lincosamide-streptogramin B resistance. Antimicrob Agents Chemother 1989; 33:78–81
    [Google Scholar]
  25. Leclercq R., Courvalin P. Bacterial resistance to macrolide, lincosamide, and streptogramin antibiotics by target modification. Antimicrob Agents Chemother 1991; 35:1267–1272
    [Google Scholar]
  26. Leclercq R., Courvalin P. Intrinsic and unusual resistance to macrolide, lincosamide, and streptogramin antibiotics in bacteria. Antimicrob Agents Chemother 1991; 35:1273–1276
    [Google Scholar]
  27. Miyamoto Y., Takizawa K., Matsushima A., Asai Y., Nakatsuka S. Stepwise acquisition of multiple drug resistance by beta-hemolytic streptococci and difference in resistance pattern by type. Antimicrob Agents Chemother 1978; 13:399–404
    [Google Scholar]
  28. Betriu C., Sanchez A., Gomez M., Cruceyra A., Picazo J. J. Antibiotic susceptibility of group A streptococci: a 6-year follow-up study. Antimicrob Agents Chemother 1993; 37:1717–1719
    [Google Scholar]
  29. Scott R. J. D., Naidoo J., Lightfoot N. F., George R. C. A community outbreak of group A beta haemolytic streptococci with transferable resistance to erythromycin. Epidemiol Infect 1989; 102:85–91
    [Google Scholar]
  30. Stingemore N., Francis G. R. J., Toohey M., McGechie D. B. The emergence of erythromycin resistance in Streptococcus pyogenes in Fremantle, Western Australia. Med J Austr 1989; 150:626–631
    [Google Scholar]
  31. Seppälä H., Nissinen A., Järvinen H. Resistance to erythromycin in group A streptococci. N Engl J Med 1992; 326:292–297
    [Google Scholar]
  32. Fernandes P. B., Garmaise D. Resistance to erythromycin. J Antimicrob Chemother 1987; 20:449–450
    [Google Scholar]
  33. Järvinen H., Nissinen A., Huovinen P. Erythromycin resistance in group A streptococci. Lancet 1989; 1:1022–1023
    [Google Scholar]
  34. Holmström L., Nyman B., Rosengren M., Wallander S., Ripa T. Outbreaks of infections with erythromycin-resistant group A streptococci in child day care centres. Scand J Infect Dis 1990; 22:179–185
    [Google Scholar]
  35. Wittier R. R., Yamada S. M., Bass J. W., Hamill R., Wiebe R. A., Ascher D. P. Penicillin tolerance and erythromycin resistance of group A ß-hemolytic streptococci in Hawaii and the Philippines. Am J Dis Child 1990; 144:587–589
    [Google Scholar]
  36. Kirst H. A., Sides G. D. New directions for macrolide antibiotics: pharmacokinetics and clinical efficacy. Antimicrob Agents Chemother 1989; 33:1419–1422
    [Google Scholar]
  37. Schrock C. G. Clarithromycin vs penicillin in the treatment of streptococcal pharyngitis. J Fam Pract 1992; 35:622–626
    [Google Scholar]
  38. Still J. G., Hubbard W. C., Poole J. M., Sheaffer C. L., Chartrand S., Jacobs R. Comparison of clarithromycin and penicillin VK suspensions in the treatment of children with streptococcal pharyngitis and review of currently available alternative antibiotic therapies. Pediatr Infect Dis J 1993; 12: Suppl 3S134–141
    [Google Scholar]
  39. Hooton T. M. A comparison of azithromycin and penicillin V for the treatment of streptococcal pharyngitis. Am J Med 1991; 91: Suppl 3A23S–26S
    [Google Scholar]
  40. Moellering R. C. Introduction: revolutionary changes in the macrolide and azalide antibiotics. Am J Med 1991; 91: Suppl 3A1S–4S
    [Google Scholar]
/content/journal/jmm/10.1099/00222615-43-5-386
Loading
/content/journal/jmm/10.1099/00222615-43-5-386
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error