RESPIRATORY-TRACT INFECTION - EPIDEMIOLOGY AND SURVEILLANCE

Streptococcus pneumoniae and Haemophilus influenzae are the key pathog ens implicated in bacterial infections of the upper and lower respirat ory tract. Choice of empiric oral antimicrobial chemotherapy is guided by the clinical presentation, severity of the infection and epidemiol ogical knowledge, beta-Lactams and the macrolides are the two major gr oups of antibiotics used to treat respiratory tract infections, The pr evalence of penicillin-resistant strains of S, pneumoniae is increasin g world-wide (up to 30% in the USA), as is the prevalence of p-lactama se-producing strains of H, influenzae. Macrolide resistance in S. pneu moniae is increasing and is absolute, and some of the macrolides have only limited activity against H, influenzae. knowledge of local and gl obal antibiotic resistance patterns should be used as the key to direc ting empiric choice of antibiotic treatment.