Pneumococcal antimicrobial resistance: the problem in Hungary.

Abstract

An epidemiological survey of penicillin resistance as determined by minimum inhibitory concentrations (MICs) in Streptococcus pneumoniae strains collected from several Hungarian laboratories in 1988-1989 indicated a prevalence of 58% among a total of 135 isolates. A significantly higher resistance rate (69.2%) was found for isolates from pediatric patients than from adult patients (44.0%). Penicillin-resistant strains were more frequently resistant to non-beta-lactam antibiotics (tetracycline, erythromycin, co-trimoxazole, and chloramphenicol) than were penicillin-sensitive strains. On the basis of the MIC50 and MIC90 values of ampicillin and five cephalosporins for penicillin-resistant strains, it was established that ampicillin and cephalexin were not superior to penicillin. The low MIC90 of ceftriaxone and cefotaxime for these organisms reflects promising therapeutic potential, even in septicemia and meningitis caused by penicillin-resistant strains. The therapeutic alternative to penicillin in the treatment of respiratory tract infection may be second-generation cephalosporins such as cefuroxime or cefamandole.