Macrolide resistance in adults with bacteremic pneumococcal pneumonia

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Abstract

We conducted a case-control study of adults with bacteremic pneumococcal pneumonia to identify factors associated with macrolide resistance. Study participants were identified through population-based surveillance in a 5-county region surrounding Philadelphia. Forty-three hospitals contributed 444 patients, who were interviewed by telephone regarding potential risk factors. In multivariable analyses, prior exposure to a macrolide antimicrobial agent (odds ratio [OR] 2.8), prior flu vaccination (OR 2.0), and Hispanic ethnicity (OR 4.1) were independently associated with an increased probability of macrolide resistance, and a history of stroke was independently associated with a decreased probability of macrolide resistance (OR 0.2). Fifty-five percent of patients with macrolide-resistant infections reported no antimicrobial drug exposure in the preceding 6 months. Among patients who reported taking antimicrobial agents in the 6 months preceding infection, failure to complete the course of prescribed drugs was associated with an increased probability of macrolide resistance (OR 3.4).

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Metlay, J. P., Fishman, N. O., Joffe, M. M., Kallan, M. J., Chittams, J. L., & Edelstein, P. H. (2006). Macrolide resistance in adults with bacteremic pneumococcal pneumonia. Emerging Infectious Diseases, 12(8), 1223–1230. https://doi.org/10.3201/eid1708.060017

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