Macrolide use identified as risk factor for macrolide-resistant Streptococcus pneumoniae in a 17-center case-control study

Eur J Clin Microbiol Infect Dis. 2006 May;25(5):335-9. doi: 10.1007/s10096-006-0137-8.


The objective of the case-control study presented here was to examine the risk factors for macrolide-resistant Streptococcus pneumoniae. As part of a 44-center U.S. surveillance study, 1,817 unique isolates of S. pneumoniae were collected from November 2002 through April 2003. Seventy-five randomly selected macrolide-resistant isolates (cases) were each matched with one susceptible control. Macrolide use in the 6 weeks prior to sample collection was reported for seven cases and one control. The final conditional logistic regression model identified two statistically significant variables: a history of alcohol abuse was protective, while macrolide use in the 6 weeks prior to sample collection was a significant risk factor for macrolide-resistant S. pneumoniae. Macrolide resistance was associated with use of any antibiotic during the prior 6 weeks, and was most strongly associated with previous macrolide use.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Drug Resistance, Bacterial
  • Erythromycin / pharmacology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Macrolides / adverse effects
  • Macrolides / therapeutic use*
  • Male
  • Middle Aged
  • Pneumococcal Infections / drug therapy*
  • Pneumococcal Infections / microbiology
  • Streptococcus pneumoniae / drug effects*
  • Streptococcus pneumoniae / isolation & purification


  • Anti-Bacterial Agents
  • Macrolides
  • Erythromycin