THE NEARCHUS PROJECT - ANTIBIOTIC SUSCEPTIBILITY OF RESPIRATORY PATHOGENS AND CLINICAL OUTCOME IN LOWER RESPIRATORY-TRACT INFECTIONS AT 27 CENTERS IN THE UK

Community-acquired respiratory infections are usually treated empirica lly by the primary care physician. Increasing antibiotic resistance, f or example, in pneumococci, prompted a UK survey of antibiotic suscept ibility of three major lower respiratory tract pathogens, Streptococcu s pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Each o f 27 centres was asked to collect up to 100 isolates of the three spec ies and submit them for confirmation of identity and for susceptibilit y testing to a central laboratory. In addition, general practitioners were asked for demographic details on the patient, their treatment and the clinical outcome. Of 1689 viable pathogens collected, there were 1078 (64%) strains of H. influenzae, 258 (15%) of M. catarrhalis and 3 53 (21%) of S. pneumoniae. Production of B-lactamase was detected in 1 63 (15%) of 1078 isolates of H. influenzae and in 243 (94%) isolates o f M. catarrhalis. For S. pneumoniae, moderate resistance to penicillin (MIC 0.12-1 mg/l) was found in 12 (3.4%) isolates and high level resi stance (MIC 12 mg/l) in 13 (3.7%) isolates. The most common individual treatments were amoxycillin, amoxycillin/clavulanate (amoxyclav), and erythromycin. Complete or partial clinical resolution was achieved in 88% of 809 patients infected with H. influenzae, 83% of 197 infected with M. catarrhalis and 90% of 255 infected with S. pneumoniae. (C) 19 98 Elsevier Science B.V./International Society of Chemotherapy. All ri ghts reserved.