Meta-analysis of bacterial resistance to macrolides

Halpern, Michael T.; Schmier, Jordana K.; Snyder, Lia M.; Asche, Carl V.; Sarocco, Phil; Lavin, Bruce; Nieman, Richard B.; Mandell, Lionel A.

doi:10.1093/jac/dki060

Cited by 27 publications

(13 citation statements)

References 39 publications

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“…If zero events occurred, a correction factor of 0.5 was applied. When the number of original studies was less than four, meta-analysis with random-effects model was only conducted to obtain an average estimate; the 95% CI was presented accordingly [21], [22], [23], [24]. To assess differences in geographic regions, poison regression was used.…”

Section: Methodsmentioning

confidence: 99%

Burden of Pneumonia and Meningitis Caused by Streptococcus pneumoniae in China among Children under 5 Years of Age: A Systematic Literature Review

et al. 2011

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Background and MethodsTo understand the burden and epidemiology of Streptococcus pneumoniae disease among children between 1 and 59 months of age in China, we conducted a review of literature published between 1980 and 2008 applying standardized algorithms. Because of the absence of population-based surveillance for pneumococcal disease (PD), we identified all-cause pneumonia, bacteremia and meningitis burden, syndromes most commonly associated with S. pneumoniae, and applied the proportion of disease attributable to S. pneumoniae from studies that determined the etiology of these three syndromes to calculate PD burden. Because of the microbiologic difficulties in identifying S. pneumoniae–attributable pneumonia which likely underestimates the pneumonia burden, we also used the proportion obtained from vaccine efficacy trials.ResultsBetween 1980 and 2008, there were 12,815 cases/100,000/year of all-cause pneumonia among children between 1 month and 59 months, with 526 deaths/100,000 annually. There were 14 meningitis cases/100,000/year. We estimate that as of 2000, there were 260,768 (113,000 to 582,382) and 902 (114–4,463) cases of pneumococcal pneumonia and meningitis, respectively with 10,703 (4,638–23,904) and 75 (9–370) pneumococcal pneumonia and meningitis deaths, respectively. Pneumococcal pneumonia cases and deaths were more than two-fold higher, 695,382 (173,845–1,216,918) and 28,542 (7,136–49,949), respectively, when parameters from efficacy trials were used. Serotypes 19F, 19A and 14 were the most common serotypes obtained from pneumonia/meningitis patients. Currently available vaccines are expected to cover 79.5% to 88.4% of the prevalent serotypes. With high antibiotic resistance, introducing pneumococcal vaccines to the routine immunization program should be considered in China. Population-based studies are warranted.

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Section: Methodsmentioning

confidence: 99%

Burden of Pneumonia and Meningitis Caused by Streptococcus pneumoniae in China among Children under 5 Years of Age: A Systematic Literature Review

et al. 2011

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“…In a meta‐analysis Halpern and colleagues (29 studies; 1998‐2003) found the mean resistance of S. pneumoniae isolates to azithromycin was 27.2% (95% CI 24.6–29.7) and to erythromycin was 30.4% (95% CI 28.1–32.7). Too few studies of clarithromycin were included to allow an accurate evaluation of resistance .…”

Section: Risks Of Long‐term Use Of Macrolidesmentioning

confidence: 99%

Long‐term macrolide treatment of chronic inflammatory airway diseases: risks, benefits and future developments

Cameron

McSharry

Chaudhuri

et al. 2012

Clin Experimental Allergy

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Macrolide antibiotics were discovered over 50 years ago and following their use as antimicrobials it became apparent that this group of antibiotics also possessed anti-inflammatory properties. Subsequent clinical trials showed benefits of macrolides as long-term adjuncts in the treatment of a spectrum of chronic inflammatory respiratory diseases, particularly diffuse panbronchiolitis, cystic fibrosis, post-transplant bronchiolitis obliterans and more recently chronic obstructive pulmonary disease (COPD). The evidence for efficacy of macrolides in the long-term treatment of chronic asthma and bronchiectasis is less well established. The mechanism(s) of action of macrolides in the treatment of these diseases remains unexplained, but may be due to their antibacterial and/or anti-inflammatory actions, which include reductions in interleukin-8 production, neutrophil migration and/or function. Macrolides have additional potentially beneficial properties including anti-viral actions and an ability to restore corticosteroid sensitivity. The increased prescribing of macrolides for long-term treatment could result in the development of microbial resistance and adverse drug effects. New macrolides have been developed which do not possess any antimicrobial activity and hence lack the ability to produce microbial resistance, but which still retain immunomodulatory effects. Potentially novel macrolides may overcome a significant barrier to the use of this type of drug for the long-term treatment of chronic inflammatory airway diseases.

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“…However, the number of pneumococcal strains showing in vitro resistance to this class of antibacterials has increased dramatically across the world in the last decade [1,2]. Although the link between resistance measured in the laboratory and adverse clinical outcome has not been fully substantiated to date, an increasing number of reports of treatment failure associated with macrolide-resistant pneumococcal infections [3,4] have raised concern over the continued clinical utility of the macrolides.…”

Section: Introductionmentioning

confidence: 99%

Distribution and antibacterial susceptibility of macrolide resistance genotypes in Streptococcus pneumoniae: PROTEKT Year 5 (2003–2004)

Farrell¹,

Couturier

Hryniewicz

2008

International Journal of Antimicrobial Agents

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Meta-analysis of bacterial resistance to macrolides

Cited by 27 publications

References 39 publications

Burden of Pneumonia and Meningitis Caused by Streptococcus pneumoniae in China among Children under 5 Years of Age: A Systematic Literature Review

Burden of Pneumonia and Meningitis Caused by Streptococcus pneumoniae in China among Children under 5 Years of Age: A Systematic Literature Review

Long‐term macrolide treatment of chronic inflammatory airway diseases: risks, benefits and future developments

Distribution and antibacterial susceptibility of macrolide resistance genotypes in Streptococcus pneumoniae: PROTEKT Year 5 (2003–2004)

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