DÄ internationalArchive4/2009Pertussis – Not Only a Disease of Childhood: Selection of Pneumococci

Correspondence

Pertussis – Not Only a Disease of Childhood: Selection of Pneumococci

Dtsch Arztebl Int 2009; 106(4): 57. DOI: 10.3238/arztebl.2009.0057c

Shah, P M

LNSLNS Are there any data from Germany about the sensitivity of pertussis strains to macrolides, trimethoprim–sulfamethoxazole, and tetracyclines, which are recommended for therapy, respectively prophylaxis (presumably post-exposure prophylaxis)? From the United States, erythromycin resistant strains of Bordetella pertussis have been reported (1). In vitro, gyrase inhibitors fluoroquinolones) have been found to be highly active, even for macrolide resistant strains; they are therefore an alternative treatment option at least in adults (2). However, a word of warning is in order against the uncritical use of azithromycin because of possible selection of resistant pneumococci. This has occurred after only a single dose of azithromycin (3). Since resistant strains exist, cultures and sensitivity testing should be the way forward. DOI: 10.3238/arztebl.2009.0057c


Prof. Dr. med. Pramod M. Shah
Gutzkowstr. 69
60594 Frankfurt am Main, Germany
infektiologie@online.de

Conflict of interest statement
The author has received honoraria as a speaker and adviser from
Sanofi-Aventis, Janssen-Cilag, and Pohl-Boskamp.
1.
Bartkus JM, Juni BA, Ehresmann K, Miller CA, Sanden GN, Cassiday PK et al.: Identification of a mutation associated with erythromycin resistance in Bordetella pertussis: implications for surveillance of antimicrobial resistance. J Clin Microbiol 2003; 41: 1167–72. MEDLINE
2.
Bourgeois N, Ghnassia JC, Doucet-Populaire F: In vitro activity of fluoroquinolones against erythromycin-susceptible and -resistant Bordetella pertussis. J Antimicrob Chemother 2003; 51: 742–3. MEDLINE
3.
Leach AJ, Shelby-James TM, Mayo M, Gratten M, Laming AC, Currie BJ et al.: A prospective study of the impact of community-based Azithromycin treatment of trachoma on carriage and resistance of Streptococcus pneumoniae. Clin Infect Dis 1997; 24: 356–62. MEDLINE
1. Bartkus JM, Juni BA, Ehresmann K, Miller CA, Sanden GN, Cassiday PK et al.: Identification of a mutation associated with erythromycin resistance in Bordetella pertussis: implications for surveillance of antimicrobial resistance. J Clin Microbiol 2003; 41: 1167–72. MEDLINE
2. Bourgeois N, Ghnassia JC, Doucet-Populaire F: In vitro activity of fluoroquinolones against erythromycin-susceptible and -resistant Bordetella pertussis. J Antimicrob Chemother 2003; 51: 742–3. MEDLINE
3. Leach AJ, Shelby-James TM, Mayo M, Gratten M, Laming AC, Currie BJ et al.: A prospective study of the impact of community-based Azithromycin treatment of trachoma on carriage and resistance of Streptococcus pneumoniae. Clin Infect Dis 1997; 24: 356–62. MEDLINE