Effect of Azithromycin on Pharyngeal Microflora

Ra, Adegbola; Ek, Mulholland; Bailey, Robin L.; Secka, Ousman; Sadiq, S Tariq; Glasgow, Kevin; Mabey, Denise

doi:10.1097/00006454-199504000-00024

Cited by 18 publications

(11 citation statements)

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“…Oropharyngeal swabs were taken before treatment and 1 month later. There was a significant reduction in the carriage of S. pneumoniae, but the susceptibility patterns were not reported (1). A study based in Nepal took conjunctival swabs for bacterial culture from 121 children before and 14 days after treatment with azithromycin at 20 mg/kg.…”

Section: Discussionmentioning

confidence: 99%

Impact of Azithromycin Administration for Trachoma Control on the Carriage of Antibiotic-Resistant Streptococcus pneumoniae

Batt

Charalambous

Solomon

et al. 2003

Antimicrob Agents Chemother

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Community distribution of azithromycin has an important role to play in trachoma control. Previous studies have suggested that this may increase the prevalence of macrolide-resistant Streptococcus pneumoniae. S. pneumoniae was isolated from children under 7 years of age in Rombo District, northern Tanzania, before and 2 and 6 months after community-wide administration of azithromycin. Overall carriage rates were 11, 12, and 7%, respectively. Only one macrolide-resistant isolate carrying the mef gene was obtained 6 months after azithromycin administration. This contrasted with cotrimoxazole and penicillin resistance, both of which were common (cotrimoxazole resistance, 42, 43, and 47%, and penicillin resistance, 21, 17, and 16% at baseline, 2 months, and 6 months, respectively). There was a significant association between cotrimoxazole and penicillin resistance (P < 0.0001, Fisher's exact). These data suggest that in communities where macrolide resistance is rare, azithromycin distribution for trachoma control is unlikely to increase the prevalence of resistant organisms.

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Section: Discussionmentioning

confidence: 99%

Impact of Azithromycin Administration for Trachoma Control on the Carriage of Antibiotic-Resistant Streptococcus pneumoniae

Batt

Charalambous

Solomon

et al. 2003

Antimicrob Agents Chemother

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“…In addition to reducing the prevalence of trachoma, mass treatment with azithromycin may have other beneficial outcomes [12,13]. Organisms that are susceptible to broadspectrum macrolides will likely be affected by a mass treatment campaign, including those that cause a variety of skin diseases, diarrhea, and acute respiratory infections [14].…”

mentioning

confidence: 99%

Adverse and Beneficial Secondary Effects of Mass Treatment with Azithromycin to Eliminate Blindness Due to Trachoma in Nepal

et al. 2002

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Mass administration of azithromycin to eliminate blindness due to trachoma has raised concerns regarding the emergence of antimicrobial resistance. During 2000, we compared the antimicrobial resistance of nasopharyngeal pneumococcal isolates recovered from and the prevalence of impetigo, respiratory symptoms, and diarrhea among 458 children in Nepal before and after mass administration of azithromycin. No azithromycin-resistant pneumococci were isolated except from 4.3% of children who had received azithromycin during 2 previous mass treatments (P<.001). There were decreases in the prevalence of impetigo (from 14% to 6% of subjects; adjusted odds ratio [OR], 0.41; 95% confidence interval [CI], 0.21-0.80) and diarrhea (from 32% to 11%; adjusted OR, 0.26; 95% CI, 0.14-0.43) 10 days after azithromycin treatment. The absence of macrolide-resistant isolates after 1 mass treatment with azithromycin is encouraging, although the recovery of azithromycin-resistant isolates after 2 mass treatments suggests the need for resistance monitoring when multiple rounds of antimicrobial treatment are given.

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“…Previous studies of trachomatous eyes also had found S pneumoniae and H influenzae to be the most common non-chlamydial ocular pathogen 18. Adegbola et al 16 found that S pneumoniae was less prevalent after azithromycin treatment, but that H influenzae was not significantly affected. In many countries, seasonal variation plays an important role in both the number and distribution of bacteria, as suggested by Peterson and Treadway 19.…”

Section: Discussionmentioning

confidence: 99%

“…The systemic administration of azithromycin has also been shown to decrease bacterial flora elsewhere in the body. Adegbola et al 16reported a decrease of S pneumoniae recoverable from the oropharynx from 73% to 24% in children after azithromycin treatment. Leach et al 17 also found a statistically significant decrease in oropharyngeal S pneumoniae from 68% at baseline to 29% 2 weeks after azithromycin dosing.…”

Section: Discussionmentioning

confidence: 99%

Alterations in the conjunctival bacterial flora following a single dose of azithromycin in a trachoma endemic area

Chern

Shrestha

Cevallos

et al. 1999

British Journal of Ophthalmology

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Background/aims-The World Health Organisation has recommended repeated mass treatment of children in trachoma endemic areas with oral azithromycin. While chlamydia, the causative agent of trachoma, remains universally sensitive to azithromycin, there is concern that large scale programmes may alter the bacterial flora and induce resistance in streptococcal species. In this study the eVect of a single dose of azithromcyin on the prevalence, species distribution, and resistance of conjunctival bacterial flora was determined. Methods-Baseline and 14 day follow up bacterial cultures were taken from the conjunctivae of 121 children who reside in a trachoma endemic area of Nepal. 91 children were treated with azithromycin at baseline and 31 children received deferred treatment at the 14 day follow up. Results-Although the prevalence of bacterial pathogens decreased significantly with azithromycin treatment, a significant change in the distribution of specific bacterial pathogens could not be demonstrated. Streptococcal resistance to azithromycin was found significantly more frequently after treatment. No change in the prevalence, distribution, or resistance pattern was found in the untreated control group. Conclusion-Repeated mass treatment of trachoma endemic areas with oral azithromycin will have an eVect on bacterial flora. However, further work needs to be done to determine if this will have any clinical relevance. (Br J Ophthalmol 1999;83:1332-1335

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Effect of Azithromycin on Pharyngeal Microflora

Cited by 18 publications

References 0 publications

Impact of Azithromycin Administration for Trachoma Control on the Carriage of Antibiotic-Resistant Streptococcus pneumoniae

Impact of Azithromycin Administration for Trachoma Control on the Carriage of Antibiotic-Resistant Streptococcus pneumoniae

Adverse and Beneficial Secondary Effects of Mass Treatment with Azithromycin to Eliminate Blindness Due to Trachoma in Nepal

Alterations in the conjunctival bacterial flora following a single dose of azithromycin in a trachoma endemic area

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