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In Vitro Activity of Oral Cephalosporins against Pediatric Isolates of Streptococcus pneumoniae Non-Susceptible to Penicillin, Amoxicillin or Erythromycin

2008; Taylor & Francis; Volume: 20; Issue: 2 Linguagem: Inglês

10.1179/joc.2008.20.2.175

1973-9478

Asunción Fenoll, María-José Giménez, Olga Robledo, L. Aguilar, David Tarragó, Juan José Granizo, Mercedes Gimeno, Pilar Coronel,

Pneumocystis jirovecii pneumonia detection and treatment

The aim of this study was to evaluate the effects of penicillin, amoxicillin or erythromycin resistance on the in vitro activity of oral cephalosporins against Streptococcus pneumoniae pediatric isolates. A total of 282 pediatric isolates received during 2005 in the Spanish Reference Pneumococcal Laboratory were tested by agar dilution: 104 strains were penicillin-susceptible, 72 intermediate, and 106 resistant. Serotypes 9 and 14 were the most troublesome with or= 32 microg/ml), with 0% susceptibility to cefaclor, cefuroxime and cefpodoxime. Cefditoren 0.5 microg/ml inhibited 95.3%, 95.5%, and 98.6% of penicillin-, amoxicillin-, and erythromycin-resistant isolates, respectively. Susceptibility to oral cephalosporins shifted from >90% in penicillin-susceptible isolates to approximately 38% for cefuroxime/cefpodoxime and approximately 7% for cefaclor in penicillin-intermediate, and to 0% in resistant isolates. Despite the different in vitro activity of oral cephalosporins, full resistance to penicillin or amoxicillin implied lack of susceptibility to all oral cephalosporins with defined CLSI breakpoints, rendering them inadequate as empirical treatment in countries with a high prevalence of penicillin resistance.