Abstract
Among 5,043 invasive pneumococcal disease (IPD) isolates identified through South African national surveillance from 2003 to 2007, we estimated the effect of trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis on antimicrobial resistance. Patients on TMP-SMX prophylaxis were more likely to have a pneumococcal isolate nonsusceptible to TMP-SMX, penicillin, and rifampin. TMP-SMX nonsusceptibility was associated with nonsusceptibility to penicillin, erythromycin, and rifampin and multidrug resistance. This study informs empirical treatment of suspected IPD in patients with a history of TMP-SMX use.
Publication types
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Research Support, Non-U.S. Gov't
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Research Support, U.S. Gov't, Non-P.H.S.
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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Adolescent
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Adult
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Aged
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Anti-Bacterial Agents / administration & dosage
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Anti-Bacterial Agents / therapeutic use*
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Child
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Child, Preschool
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Drug Resistance, Multiple, Bacterial*
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Erythromycin / administration & dosage
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Erythromycin / therapeutic use
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Female
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Humans
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Infant
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Infant, Newborn
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Longitudinal Studies
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Male
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Middle Aged
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Penicillins / administration & dosage
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Penicillins / therapeutic use
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Pneumococcal Infections / epidemiology
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Pneumococcal Infections / microbiology
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Pneumococcal Infections / prevention & control*
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Population Surveillance
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Rifampin / administration & dosage
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Rifampin / therapeutic use
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South Africa / epidemiology
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Streptococcus pneumoniae / drug effects*
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Streptococcus pneumoniae / isolation & purification
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Streptococcus pneumoniae / physiology
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Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage
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Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use*
Substances
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Anti-Bacterial Agents
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Penicillins
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Erythromycin
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Trimethoprim, Sulfamethoxazole Drug Combination
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Rifampin