Dohar Joseph, Cantón Rafael, Cohen Robert, Farrell David John, Felmingham David
Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, USA.
Ann Clin Microbiol Antimicrob. 2004 Aug 2;3:15. doi: 10.1186/1476-0711-3-15.
Increasing antimicrobial resistance among the key pathogens responsible for community-acquired respiratory tract infections has the potential to limit the effectiveness of antibiotics available to treat these infections. Since there are regional differences in the susceptibility patterns observed and treatment is frequently empirical, the selection of antibiotic therapy may be challenging. PROTEKT, a global, longitudinal multicentre surveillance study, tracks the activity of telithromycin and comparator antibacterial agents against key respiratory tract pathogens.
In this analysis, we examine the prevalence of antibacterial resistance in 1,336 bacterial pathogens, isolated from adult and paediatric patients clinically diagnosed with acute bacterial sinusitis (ABS).
In total, 58.0%, 66.1%, and 55.8% of S. pneumoniae isolates were susceptible to penicillin, cefuroxime, and clarithromycin respectively. Combined macrolide resistance and reduced susceptibility to penicillin was present in 200/640 (31.3 %) of S. pneumoniae isolates (128 isolates were resistant to penicillin [MIC > or = 2 mg/L], 72 intermediate [MIC 0.12-1 mg/L]) while 99.5% and 95.5% of isolates were susceptible to telithromycin and amoxicillin-clavulanate, respectively. In total, 88.2%, 87.5%, 99.4%, 100%, and 100% of H. influenzae isolates were susceptible to ampicillin, clarithromycin, cefuroxime, telithromycin, and amoxicillin-clavulanate, respectively. In vitro, telithromycin demonstrated the highest activity against M. catarrhalis (MIC50 = 0.06 mg/L, MIC90 = 0.12 mg/L).
The high in vitro activity of against pathogens commonly isolated in ABS, together with a once daily dosing regimen and clinical efficacy with 5-day course of therapy, suggest that telithromycin may play a role in the empiric treatment of ABS.
引起社区获得性呼吸道感染的主要病原体的抗菌耐药性不断增加,可能会限制现有抗生素治疗这些感染的有效性。由于观察到的药敏模式存在地区差异,且治疗通常是经验性的,因此选择抗生素治疗可能具有挑战性。PROTEKT是一项全球纵向多中心监测研究,追踪了泰利霉素和对照抗菌药物对主要呼吸道病原体的活性。
在本分析中,我们检测了从临床诊断为急性细菌性鼻窦炎(ABS)的成人和儿童患者中分离出的1336株细菌病原体的抗菌耐药率。
总的来说,分别有58.0%、66.1%和55.8%的肺炎链球菌分离株对青霉素、头孢呋辛和克拉霉素敏感。200/640(31.3%)的肺炎链球菌分离株存在大环内酯类耐药和对青霉素敏感性降低的情况(128株对青霉素耐药[MIC≥2mg/L],72株中介[MIC 0.12-1mg/L]),而99.5%和95.5%的分离株分别对泰利霉素和阿莫西林-克拉维酸敏感。总的来说,分别有88.2%、87.5%、99.4%、100%和100%的流感嗜血杆菌分离株对氨苄西林、克拉霉素、头孢呋辛、泰利霉素和阿莫西林-克拉维酸敏感。在体外,泰利霉素对卡他莫拉菌的活性最高(MIC50 = 0.06mg/L,MIC90 = 0.12mg/L)。
泰利霉素对ABS中常见病原体的体外活性高,加上每日一次给药方案以及5天疗程治疗的临床疗效,表明泰利霉素可能在ABS的经验性治疗中发挥作用。