Efficacy of β-lactamase-resistant penicillin and influence of penicillin tolerance in eradicating streptococci from the pharynx after failure of penicillin therapy for group A streptococcal pharyngitis

Smith, Thomas D.; Huskins, W. Charles; Klm, Kwang Sik; Kalan, Edward L.

doi:10.1016/s0022-3476(87)80023-9

Cited by 83 publications

(34 citation statements)

References 19 publications

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“…Bacteriologic failure rates as high as 25%-30% were reported during the next several years [4]. These incompletely explained observations were made just before and at the time when the current resurgence of group A streptococcus infections and their sequelae was beginning to be observed.…”

Section: Group a /3-hemolytic Streptococcimentioning

confidence: 99%

Recent Evaluation of Antimicrobial Resistance in β-Hemolytic Streptococci

Kaplan

1997

Clinical Infectious Diseases

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Although antimicrobial resistance among bacteria continues to increase and to be a clinical problem, the /3-hemolytic streptococci have remained remarkably susceptible to most antibiotics. For example, there has not been a single documented instance of a clinical isolate of a penicillinresistant group A streptococcus. Moreover, available data indicate that the minimal inhibitory concentrations (MICs) of penicillin for group A streptococci have not changed during the past 4 decades. In one study, the MIC90 for more than 300 strains of group A streptococci was only 0.012 iLg/mL. Resistance to the macrolide antibiotics, the tetracyclines, and the sulfa drugs remains more clinically important. Outbreaks of macrolide resistance have been documented in several parts of the world, but macrolide resistance in most countries of the world remains at <5% among group A streptococci. Despite the fact that clinically significant antibiotic resistance has not emerged, careful surveillance is required.

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Section: Group a /3-hemolytic Streptococcimentioning

confidence: 99%

Recent Evaluation of Antimicrobial Resistance in β-Hemolytic Streptococci

Kaplan

1997

Clinical Infectious Diseases

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“…However, there is growing concern about the therapeutic failures and recurrences (up to 30%) following an adequate 10-day course with oral penicillin for the treatment of acute pharyngotonsillitis. Speculation has developed about the role of ß-lactamase production by the pharyngeal flora rendering penicillin less effective, about poor compliance, or tolerance of some GABHS strains to penicillin [2,3].…”

Section: Introductionmentioning

confidence: 99%

In vitro Activity of Moxifloxacin Compared to Other Fluoroquinolones against Different Erythromycin-Resistant Phenotypes of Group A β-hemolytic <i>Streptococcus</i>

Esposito¹,

Noviello

Ianniello

et al. 1999

Chemotherapy

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The aim of the present study was to evaluate the in vitro activity of moxifloxacin (BAY 12–8039) compared to ciprofloxacin, ofloxacin and sparfloxacin against 156 group A β-hemolytic Streptococcus strains. Sixty strains were macrolide-, lincosamide- and streptogramin-B-susceptible; 16 strains exhibited a constitutive resistance phenotype; 32 strains exhibited an inducible phenotype, and 48 strains were characterized by the M-type efflux-dependent phenotype. The minimum inhibition concentrations were determined by an agar dilution method according to NCCLS-approved guidelines. Moxifloxacin showed an enhanced activity compared with the other fluoroquinolones against the different macrolide-resistant phenotypes.

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“…If our conjectures are correct then penicillin tolerance may reflect the mode of transmission and/or previous administration of antibiotics. The role of penicilfin-tolerant group A streptococci in the severity of pharyngitis and in failure of treatment is still controversial, some investigators suggesting a causative role (5, 6) while others found no such relationship (7,8). Although in the present report the epidemics associated with penicillin tolerant group A streptococci persisted longer than those caused by nontolerant strains, it is difficult to draw any conclusions since the modes of transmission and populations were entirely different.…”

Section: Remits and Discussionmentioning

confidence: 53%

Association of penicillin-tolerant streptococci with epidemics of streptococcal pharyngitis in closed communities

Dagan

Ferne

1989

Eur. J. Clin. Microbiol. Infect. Dis.

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The association of penicillin-tolerant streptococci with reported epidemics of streptococcal pharyngitis in Israel was studied. The streptococcal strains had been isolated during 11 epidemics of community-acquired pharyngitis and 6 food-borne epidemics of pharyngitis occurring in the last 15 years. Strains were stocked lyophilized. Isolates were defined as tolerant if the MBC/MIC ratio for penicillin was greater than or equal to 32. All 122 group A streptococcal strains isolated during the epidemics of community-acquired infection showed tolerance to penicillin. In contrast, none of the 52 strains from food-borne epidemics (24 group A, 18 group C and 8 group G) was tolerant.

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Efficacy of β-lactamase-resistant penicillin and influence of penicillin tolerance in eradicating streptococci from the pharynx after failure of penicillin therapy for group A streptococcal pharyngitis

Cited by 83 publications

References 19 publications

Recent Evaluation of Antimicrobial Resistance in β-Hemolytic Streptococci

Recent Evaluation of Antimicrobial Resistance in β-Hemolytic Streptococci

In vitro Activity of Moxifloxacin Compared to Other Fluoroquinolones against Different Erythromycin-Resistant Phenotypes of Group A β-hemolytic <i>Streptococcus</i>

Association of penicillin-tolerant streptococci with epidemics of streptococcal pharyngitis in closed communities

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