Penicillin Tolerance and Erythromycin Resistance of Group A β-Hemolytic Streptococci in Hawaii and the Philippines

Wittler, Robert R.; Yamada, Steven M.; Bass, James W.; Hamill, R J; Wiebe, Robert A.; Ascher, David P.

doi:10.1001/archpedi.1990.02150290081033

Cited by 20 publications

(8 citation statements)

References 18 publications

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“…In 1959, Lowburry and Hurst (14) first reported the decreased potency of erythromycin against S. pyogenes isolates. Since then, similar observations have been reported in many parts of the world (3,10,12,15,19,(20)(21)(22)24). In most countries, erythromycin shows limited activity against only a few clinical isolates of S. pyogenes.…”

supporting

confidence: 74%

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Decreased activity of erythromycin against Streptococcus pyogenes in Taiwan

Hsueh

Chen

Huang

et al. 1995

Antimicrob Agents Chemother

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A total of 78 clinical isolates of Streptococcus pyogenes were collected from January 1992 through December 1993 from patients in southern Taiwan. The in vitro activities of 10 antimicrobial agents were determined by the agar dilution method. Penicillin, cephalothin, cefotaxime, vancomycin, and ofloxacin were shown to be active against S. pyogenes isolates, with MICs at which 90% of isolates are inhibited (MIC 90 s) being <0.03, <0.13, <0.13, <0.13, and <0.25 g/ml, respectively. Erythromycin and azithromycin both had poor activities (MIC 50 s, 16 and >128 g/ml, respectively; MIC 90 s, >128 and >128 g/ml, respectively). The activities of tetracycline, clindamycin, and chloramphenicol against a significant number of these isolates were also limited. As the MICs of clindamycin and chloramphenicol for the isolates increased, the MICs of the two macrolides also increased. Clindamycin, chloramphenicol, and the two macrolides were less potent against isolates recovered from throat swab samples than against those from blood or other sources. Isolates of the T12 and T1 serotypes accounted for 53.8% of all isolates. The majority (87.5%) of the isolates recovered from throat swab samples were of the T12 serotype, whereas 19.2% of the isolates recovered from blood were of the T12 serotype. In contrast, 66.7% of the isolates of the T1 serotype were derived from blood but none were derived from throat swab samples. Of the 33 T12 serotype isolates, erythromycin MICs for 78.8% of the isolates were >128 g/ml. Because of the poor activities of erythromycin and azithromycin against S. pyogenes isolates from patients in southern Taiwan, these drugs should no longer be considered the drugs of choice for the management of group A streptococcal infections among patients who live in this area.

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confidence: 74%

“…For the isolates in the United States and Europe for which erythromycin MICs were high the MICs of clindamycin were still low (3,5,6,10,11,(20)(21)(22)24). Because of this, clindamycin has been recommended as a drug of choice secondary to erythromycin.…”

Section: Discussionmentioning

confidence: 99%

Decreased activity of erythromycin against Streptococcus pyogenes in Taiwan

Hsueh

Chen

Huang

et al. 1995

Antimicrob Agents Chemother

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“…Erythromycin resistance among the Hawaiian GAS isolates (3.1%) was lower than the 5.5% overall macrolide resistance rate found in the 2000-to-2001 PROTEKT US study and also lower than that found in a 2000-to-2003 U.S. surveillance study (8,21). It is of interest that while Wittler et al reported higher levels of resistance (9.5%) to erythromycin in a limited number of Hawaiian isolates a decade earlier (23), data from the present evaluation of a much larger number of GAS isolates indicated lower resistance rates in Hawaii. We are unable to compare present M protein types and sites of isolation with those reported in Wittler's earlier study.…”

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confidence: 73%

Erythromycin-Resistant Group A Streptococcal Isolates Collected between 2000 and 2005 in Oahu, Hawaii, and Their emm Types

et al. 2005

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“…16 Also, there has been a tendency toward increased frequencies of emergence of EM-resistant group A streptococci. [17][18][19] Therefore, we were prompted to postulate that these clinical profiles seemed to be related to the emergence of isolates with high toxicity, or to the emergence of resistant strains. Jung et al 5 reported that the resistance rate of group A streptococci to EM in Korea was 2% in 1994 and increased to 16% in 1998.…”

Section: Discussionmentioning

confidence: 99%