INFECTION WITH STREPTOCOCCUS-PNEUMONIAE MODERATELY RESISTANT TO PENICILLIN DOES NOT ALTER CLINICAL OUTCOME

Increasingly, drug-resistant Streptococcus pneumoniae is an identified pathogen causing pneumonia, sepsis, and meningitis. Our study evaluat ed outcome variables of patients infected with strains of S. pneumonia e moderately resistant to penicillin. We retrospectively analyzed the data on 110 Huntington, West Virginia, community patients who had type s 6, 9, 14, 19, and 23 pneumococcal infections between 1982 and 1994. These strains are most likely to demonstrate resistance. Comparing pat ients infected with sensitive vs. moderately resistant pneumococcal st rains, we found no significant difference in days in the hospital (10. 9 vs. 11.1, P =.96), days of fever (2.4 vs. 2.8, P =.74), or mortality (21% vs. 19%, P =.15). Antibiotic selection did not significantly aff ect case fatality rates in the two groups-treated with penicillin or a mpicillin alone, 16% vs. 11%, Odds Ratio = 1.50 +/- 1.73; P = .38; tre ated with an antibiotic other than penicillin, 24% vs. 28%, Odds Ratio = 0.77 +/- 0.69; P =.27). No significant differences occurred between groups regarding type of infectious process (P =.94). We conclude tha t infection with pneumococcal strains of moderate resistance to penici llin does not affect clinical outcome.