Ringertz S, Kronvall G
Scand J Infect Dis. 1987;19(2):247-56. doi: 10.3109/00365548709032407.
The use of erythromycin in Sweden has increased since 1975. An increasing prevalence of Haemophilus influenzae (H.i.) with reduced susceptibility to erythromycin has been noted in our laboratory during the years 1980 to 1985. The largest consumers of erythromycin were found to be children less than 4 years of age. Variations in resistance level of H.i. isolated from patients within this age group and variations in consumption of erythromycin were analysed for each year. The highest prevalence of resistant strains was found during spring and summer. The consumption of the antibiotic was highest during the first quarter of the year, gradually decreasing, and increasing sharply again during the fourth quarter of the year. Judging also from deviations from this pattern there seems to be an association between consumption and resistance. The different levels of resistance reported in the literature may reflect different populations of patients with different consumption of erythromycin, and different levels at different time of the year. Considering the present high level of H.i. with decreased susceptibility to erythromycin the drug is not likely to have clinical effect in H.i. infections.
自1975年以来，瑞典红霉素的使用量有所增加。1980年至1985年间，我们实验室注意到对红霉素敏感性降低的流感嗜血杆菌（H.i.）患病率不断上升。发现红霉素的最大消费群体是4岁以下的儿童。每年分析该年龄组患者分离出的H.i.耐药水平变化以及红霉素消费量变化。耐药菌株的患病率在春季和夏季最高。抗生素的消费量在一年的第一季度最高，随后逐渐下降，在第四季度再次急剧上升。从这种模式的偏差来看，消费量与耐药性之间似乎存在关联。文献中报道的不同耐药水平可能反映了不同的患者群体，他们使用红霉素的量不同，且一年中不同时间的耐药水平也不同。鉴于目前对红霉素敏感性降低的H.i.水平较高，该药在H.i.感染中不太可能产生临床效果。
