Macrolide Resistance in Adults with Bacteremic Pneumococcal Pneumonia

• Main Authors: Joshua P. Metlay, Neil O. Fishman, Marshall M. Joffe, Michael J. Kallan, Jesse L. Chittams, Paul H. Edelstein
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2006-08-01
• Series: Emerging Infectious Diseases
• Subjects: antibacterial agents; microbial drug resistance; Streptococcus pneumoniae; research; United States
• Online Access: https://wwwnc.cdc.gov/eid/article/12/8/06-0017_article
• ISSN: 1080-6040; 1080-6059

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).