ABSTRACT
In a prospective study of acute pharyngitis in Italian children, 69 (38.3%) of 180 isolates of Streptococcus pyogenes were resistant to macrolides. S. pyogenes was eradicated in 12 (63.1%) of 19 patients with erythromycin-resistant S. pyogenes treated with clarithromycin and in 22 (88%) of 25 patients with erythromycin-susceptible strains. The constitutive-resistant phenotype was correlated with failure of macrolide treatment.
Subject(s)
Anti-Bacterial Agents/pharmacology , Erythromycin/pharmacology , Pharyngitis/drug therapy , Pharyngitis/microbiology , Streptococcal Infections/drug therapy , Streptococcal Infections/microbiology , Streptococcus pyogenes/drug effects , Adolescent , Child , Child, Preschool , Clarithromycin/therapeutic use , Drug Resistance, Microbial , Humans , Infant , Italy , Microbial Sensitivity Tests , Phenotype , Prospective Studies , Streptococcus pyogenes/isolation & purificationABSTRACT
Antibiotic consumption and expenditure was studied during 1993 and 1995 in G. Gaslini children's hospital, an Italian 400-bed paediatric hospital, to see if any changes in use had occurred. There was an increase in the cost of antibacterial agents from 1993 to 1995, with a decrease in the daily cost of antibiotics and in the consumption of antiviral, antifungal and antiparasitic agents. There was a notable increase in the use of glycopeptides and carbapenems between 1995 and 1993 especially in specialities such as onco-haematology and intensive care. We suggest a basis for an antibiotic management programme aimed at reducing costs while still providing a high standard of care for patients.
