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Antimicrobial Agents and Chemotherapy, September 2003, p. 2765-2769, Vol. 47, No. 9
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.9.2765-2769.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Impact of Azithromycin Administration for Trachoma Control on the Carriage of Antibiotic-Resistant Streptococcus pneumoniae

Sarah L. Batt,1 Bambos M. Charalambous,1 Anthony W. Solomon,2,3,4 Charles Knirsch,5 Patrick A. Massae,3 Salesia Safari,3 Noel E. Sam,4 Dean Everett,1 David C. W. Mabey,2 and Stephen H. Gillespie1*

Department of Medical Microbiology, University College London, Royal Free Campus, London NW3 2PF,1 London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom,2 Huruma Hospital, Huruma,3 Clinical Laboratory, Kilimanjaro Christian Medical College, Moshi, Tanzania,4 Pfizer Inc., New York, New York 10017-57555

Received 13 February 2003/ Returned for modification 4 March 2003/ Accepted 9 June 2003

Community distribution of azithromycin has an important role to play in trachoma control. Previous studies have suggested that this may increase the prevalence of macrolide-resistant Streptococcus pneumoniae. S. pneumoniae was isolated from children under 7 years of age in Rombo District, northern Tanzania, before and 2 and 6 months after community-wide administration of azithromycin. Overall carriage rates were 11, 12, and 7%, respectively. Only one macrolide-resistant isolate carrying the mef gene was obtained 6 months after azithromycin administration. This contrasted with cotrimoxazole and penicillin resistance, both of which were common (cotrimoxazole resistance, 42, 43, and 47%, and penicillin resistance, 21, 17, and 16% at baseline, 2 months, and 6 months, respectively). There was a significant association between cotrimoxazole and penicillin resistance (P < 0.0001, Fisher's exact). These data suggest that in communities where macrolide resistance is rare, azithromycin distribution for trachoma control is unlikely to increase the prevalence of resistant organisms.

* Corresponding author. Mailing address: Department of Medical Microbiology, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, United Kingdom. Phone: 020 7794 0500, ext 3539. Fax: 020 7794 0433. E-mail: stepheng{at}rfc.ucl.ac.uk.

Antimicrobial Agents and Chemotherapy, September 2003, p. 2765-2769, Vol. 47, No. 9
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.9.2765-2769.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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