Korean J Pediatr.  2005 Jan;48(1):40-47.

Penicillin Resistant Distribution and in-vitro Susceptibility of Oral Antibiotics against Streptococcus pneumoniae, isolated from Pediatric Patients with Community- Acquired Respiratory Infections in Korea

• Kang JH
• Kim SM
• Kim JH
• Kyun HJ
• Lee KY
• Shin YK
• Park SE
• Ma SH
• Hong YJ

Abstract

PURPOSE
S. pneumoniae is one of major pathogens of community-acquired respiratory infections. The rate of antibiotic resistance to this organism has increased, and resistance to multiple antimicrobial agents in a single strain of S. pneumoniae may compromise the efficacy of empiric antimicrobial treatment commonly used for respiratory infections. We did this study to find out the penicillin resistant distributions and oral antibiotics susceptibility patterns against S. pneumoniae, isolated from pediatric patients with community-acquired respiratory infections in Korea.
METHODS
One hundred fifty six pneumococcal isolates obtained from pediatric patients with community-acquired respiratory infections such as acute otitis media(AOM), sinusitis and pneumonia between May 2000 to June 2003. And MICs of penicillin and oral antibiotics(amoxicillin, amoxicillin- clavulanate, cefaclor) were performed by broth microdilution methods according to the NCCLS(2003a).
RESULTS
Seventy eight percent of the isolates were resistant to penicillin. The isolates, collected from AOM patients showed the highest penicillin resistance(92.7%). The resistant rates of amoxicillin (16.7%) and amoxicillin-clavulanate(9.6%), based on susceptibility breakpoints established by the NCCLS, were markedly lower than these of penicillin. But, the resistant rate of cefaclor was very high, above 95%.
CONCLUSION
We concluded that pneumococci isolated from study cases may be one of the world's highest penicillin resistant rates. But, amoxicillin and amoxicillin-clavulanate can be used as a first- line antibiotics. Finally, we hope that a continuous surveillance study to monitor resistant patterns of pneumococcal respiratory infections will be needed for the standard guidelines of empiric antibiotic treatment.

Keyword

Respiratory tract infection; Community-acquired infections; Streptococcus pneumoniae; Penicillin resistance; Antibiotic susceptibility

MeSH Terms

Amoxicillin
Anti-Bacterial Agents*
Anti-Infective Agents
Cefaclor
Clavulanic Acid
Community-Acquired Infections
Drug Resistance, Microbial
Hope
Humans
Korea*
Otitis
Penicillin Resistance
Penicillins*
Pneumonia
Respiratory Tract Infections*
Sinusitis
Streptococcus pneumoniae*
Streptococcus*
Amoxicillin
Anti-Bacterial Agents
Anti-Infective Agents
Cefaclor
Clavulanic Acid
Penicillins