RESISTANT PNEUMOCOCCI - PROTECTING PATIENTS THROUGH JUDICIOUS USE OF ANTIBIOTICS

Increasing resistance to antimicrobial agents has occurred among many pathogens, but the emergence of resistant Streptococcus pneumoniae wil l have the greatest impact on the practice of outpatient medicine. Con sequences of resistance include complicated management of acute otitis media and meningitis treatment failures. Pneumococci have acquired re sistance to penicillin, third-generation cephalosporins and other anti biotics at an alarming rate; in some areas, 25 percent of isolates are nonsusceptible to penicillin. In areas with high resistance rates, th e addition of vancomycin to cefotaxime or ceftriaxone is warranted for empiric treatment of bacterial meningitis. Changes in empiric therapy for pneumonia, bacteremia and otitis media may eventually be necessar y. Previous antibiotic use is a risk factor for invasive disease with resistant pneumococci. Patients may be best protected by avoiding unne cessary use of antibiotics. Patient education materials as well as rec ommendations for avoiding the use of antibiotics for some upper respir atory tract infections are currently being developed to help physician s achieve this goal.