Resistance among Streptococcus pneumoniae: Implications for drug selection

Clin Infect Dis. 2002 Jun 15;34(12):1613-20. doi: 10.1086/340400. Epub 2002 May 16.


Streptococcus pneumoniae is an important pathogen in many community-acquired respiratory infections in the United States and a leading cause of morbidity and mortality worldwide. Unfortunately, S. pneumoniae is becoming increasingly resistant to a variety of antibiotics. Results of recent surveillance studies in the United States show that the prevalence of penicillin-nonsusceptible S. pneumoniae ranges from 25% to >50%, and rates of macrolide resistance among pneumococci are reported to be as high as 31%. A high prevalence of resistance to other antimicrobial classes is found among penicillin-resistant strains. Newer quinolones (e.g., gatifloxacin, gemifloxacin, and moxifloxacin) that have better antipneumococcal activity in vitro are the most active agents and therefore are attractive options for treatment of adults with community-acquired respiratory infections. Efforts should be made to prevent pneumococcal infections in high-risk patients through vaccination.

Publication types

  • Review

MeSH terms

  • 4-Quinolones
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Infective Agents / pharmacology
  • Drug Resistance / genetics
  • Drug Resistance, Multiple / genetics*
  • Gene Frequency
  • Humans
  • Macrolides
  • Microbial Sensitivity Tests
  • Pneumococcal Vaccines / therapeutic use
  • Pneumonia, Pneumococcal / prevention & control
  • Streptococcus pneumoniae / drug effects*
  • Streptococcus pneumoniae / genetics
  • Tetracycline / pharmacology
  • Trimethoprim, Sulfamethoxazole Drug Combination / pharmacology


  • 4-Quinolones
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Macrolides
  • Pneumococcal Vaccines
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Tetracycline