Will Reduction of Antibiotic Use Reduce Antibiotic... : The Pediatric Infectious Disease Journal (original) (raw)

Supplement: Supplement Article

The Pneumococcus Paradigm

Dagan, Ron MD*†; Barkai, Galia MD*†; Leibovitz, Eugene MD*†; Dreifuss, Eli MA‡; Greenberg, David MD*†

From the *Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel; †Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; and ‡Israel General Health Insurance Plan, Beer-Sheva, Israel.

Address for correspondence: Ron Dagan, Pediatric Infectious Disease Unit, Soroka University Medical Center, P.O. Box 151, Beer-Sheva 84101, Israel. E-mail [email protected].

Abstract

Community-acquired respiratory infections in general, and those caused by S. pneumoniae in particular, are the main reason for prescribing antimicrobials in young children. Antibiotic drug abuse is common. This is the basis for the initiative for the reduction in antibiotic use. However, failure to consider that not all antibiotics are similar in their effect on promotion of resistance has led to continuous emerging resistance. In the present article, the trends in prescribing antibiotics in young children and their interrelation with antibiotic resistance among clinical respiratory isolates of S. pneumoniae in children will be reviewed, along with theoretical considerations and research evidence that led to concluding that among antibiotics, the least resistance-promoting drug for S. pneumoniae is amoxicillin (+/− clavulanate), whereas oral cephalosporins and azithromycin demonstrate a higher resistance-promotion potential in the individual population in the community. Although antibiotics differ in their resistant-promotion potential, all still do promote resistance.