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Clinical implications of macrolide resistance in community-acquired respiratory tract infections.
Expert Rev Anti Infect Ther. 2006 Dec; 4(6):973-80.ER

Abstract

Laboratory surveillance data suggest that macrolide resistance among Streptococcus pneumoniae has increased dramatically over the past 15 years. This review examines the specifics of macrolide resistance and the clinical relevance of in vitro susceptibility testing in light of the pharmacokinetics and pharmacodynamics of azithromycin and clarithromycin. These drugs concentrate extensively within respiratory tissue and have other positive characteristics not reflected by in vitro susceptibility testing. In general, clarithromycin is the most potent macrolide and the one most likely to maintain clinical efficacy against the low-level resistance associated with most macrolide-resistant pneumococci in the USA. These findings suggest that susceptibility data may underestimate clinical utility and that clarithromycin still has a place in the empiric treatment of respiratory infections.

Authors+Show Affiliations

Health Science Centre, Department of Medical Microbiology, MS673 Thorlakson Building, 820, Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada. dhoban@hsc.mb.caNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17181414

Citation

Hoban, Daryl J., and George G. Zhanel. "Clinical Implications of Macrolide Resistance in Community-acquired Respiratory Tract Infections." Expert Review of Anti-infective Therapy, vol. 4, no. 6, 2006, pp. 973-80.
Hoban DJ, Zhanel GG. Clinical implications of macrolide resistance in community-acquired respiratory tract infections. Expert Rev Anti Infect Ther. 2006;4(6):973-80.
Hoban, D. J., & Zhanel, G. G. (2006). Clinical implications of macrolide resistance in community-acquired respiratory tract infections. Expert Review of Anti-infective Therapy, 4(6), 973-80.
Hoban DJ, Zhanel GG. Clinical Implications of Macrolide Resistance in Community-acquired Respiratory Tract Infections. Expert Rev Anti Infect Ther. 2006;4(6):973-80. PubMed PMID: 17181414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical implications of macrolide resistance in community-acquired respiratory tract infections. AU - Hoban,Daryl J, AU - Zhanel,George G, PY - 2006/12/22/pubmed PY - 2007/2/13/medline PY - 2006/12/22/entrez SP - 973 EP - 80 JF - Expert review of anti-infective therapy JO - Expert Rev Anti Infect Ther VL - 4 IS - 6 N2 - Laboratory surveillance data suggest that macrolide resistance among Streptococcus pneumoniae has increased dramatically over the past 15 years. This review examines the specifics of macrolide resistance and the clinical relevance of in vitro susceptibility testing in light of the pharmacokinetics and pharmacodynamics of azithromycin and clarithromycin. These drugs concentrate extensively within respiratory tissue and have other positive characteristics not reflected by in vitro susceptibility testing. In general, clarithromycin is the most potent macrolide and the one most likely to maintain clinical efficacy against the low-level resistance associated with most macrolide-resistant pneumococci in the USA. These findings suggest that susceptibility data may underestimate clinical utility and that clarithromycin still has a place in the empiric treatment of respiratory infections. SN - 1744-8336 UR - https://www.unboundmedicine.com/medline/citation/17181414/Clinical_implications_of_macrolide_resistance_in_community_acquired_respiratory_tract_infections_ L2 - https://www.tandfonline.com/doi/full/10.1586/14787210.4.6.973 DB - PRIME DP - Unbound Medicine ER -