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Antimicrobial Agents and Chemotherapy, July 2008, p. 2480-2485, Vol. 52, No. 7
0066-4804/08/$08.00+0     doi:10.1128/AAC.01118-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Connection between Trimethoprim-Sulfamethoxazole Use and Resistance in Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis{triangledown}

Pauliina Kärpänoja,1* Solja T. Nyberg,2 Miika Bergman,3 Tinna Voipio,4 Pirkko Paakkari,4 Pentti Huovinen,2 Hannu Sarkkinen,1 and the Finnish Study Group for Antimicrobial Resistance (FiRe Network),{dagger}

Päijät-Häme Social and Health Care Group, Clinical Microbiology, Lahti, Finland,1 National Public Health Institute, Department of Human Microbial Ecology and Inflammation, Turku, Finland,2 National Public Health Institute, Department of Bacterial and Inflammatory Diseases, Antimicrobial Research Laboratory, Turku, Finland,3 National Agency for Medicines, Helsinki, Finland4

Received 24 August 2007/ Returned for modification 23 October 2007/ Accepted 18 April 2008

The association between trimethoprim-sulfamethoxazole use and resistance among the major respiratory tract pathogens was investigated by comparing regional consumption of the drug to regional resistance in the following year in 21 central hospital districts in Finland. A total of 23,530 Streptococcus pneumoniae isolates, 28,320 Haemophilus influenzae isolates, and 14,138 Moraxella catarrhalis isolates were tested for trimethoprim-sulfamethoxazole susceptibility during the study period (1998-2004). Among the S. pneumoniae isolates, a statistically significant connection was found between regional consumption and resistance. No statistically significant connection was found between regional trimethoprim-sulfamethoxazole use and resistance among H. influenzae and M. catarrhalis isolates. According to our results, it seems that only in pneumococci can the development of trimethoprim-sulfamethoxazole resistance be influenced by restricting its use. However, trimethoprim-sulfamethoxazole remains an important antimicrobial agent because of its reasonable price. Hence, resistance to trimethoprim-sulfamethoxazole among these pathogens needs continuous monitoring.

* Corresponding author. Mailing address: Päijät-Häme Social and Health Care Group, Clinical Microbiology, Keskussairaalankatu 7, SF-15850 Lahti, Finland. Phone: 358 3 819 2459. Fax: 358 3 819 2875. E-mail: pauliina.karpanoja{at}phsotey.fi

{triangledown} Published ahead of print on 28 April 2008.

{dagger} Members of the FiRe Network are listed in Acknowledgments.

Antimicrobial Agents and Chemotherapy, July 2008, p. 2480-2485, Vol. 52, No. 7
0066-4804/08/$08.00+0     doi:10.1128/AAC.01118-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Seputiene, V., Povilonis, J., Ruzauskas, M., Pavilonis, A., Suziedeliene, E. (2010). Prevalence of trimethoprim resistance genes in Escherichia coli isolates of human and animal origin in Lithuania. J Med Microbiol 59: 315-322 [Abstract] [Full Text]  
  • Bergman, M., Nyberg, S. T., Huovinen, P., Paakkari, P., Hakanen, A. J., and the Finnish Study Group for Antimicrobial Resi, (2009). Association between Antimicrobial Consumption and Resistance in Escherichia coli. Antimicrob. Agents Chemother. 53: 912-917 [Abstract] [Full Text]  


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