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J Paediatr Child Health. 1999 Dec;35(6):558-61.

Antibiotic resistance in Streptococcus pneumoniae isolated from children.

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National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.



To determine the level of antibiotic resistance in pneumoniae (S. pneumoniae) isolated from nasal swabs of healthy children.


Cross-sectional community survey.


Survey was undertaken in general practice settings in Canberra during March and April 1998.


Four hundred and sixty-one children under 3 years of age enrolled in general practice trial of clinical practice guidelines for antibiotic use.


Resistance to penicillin, erythromycin, co-trimoxazole, tetracycline, chloramphenicol and cefotaxime among the isolates of S. pneumoniae.


A total of 461 nasal swabs were collected and S. pneumoniae was isolated from 171 (37.1%). Penicillin resistance was found in 12.3% of these isolates, with high level resistance in 0.6%. Resistance rates were higher for cotrimoxazole (44.4%) and erythromycin (18.1%) than for penicillin. Multidrug resistance was found in 19% of these isolates. There was a significant association between the attendance at a day care centre and carriage of pneumococcus (53% vs 32%, odds ratio (OR) 2.4, 95% confidence interval (CI) 1.5-3.7, P < 0.001). Children who attended day care centers and had received antibiotics during the 4 months prior to swab collection were three times more likely to carry an antibiotic-resistant isolate than children who had neither attended a day care centre nor received antibiotics (68% vs 40%, OR 3.1, 95% CI 1.2-8.4, P = 0.02).


The level of antibiotic resistance in pneumococci from healthy children was of concern. Carriage of pneumococcus was significantly higher in children who attended a day care centre. Resistance was significantly correlated with antibiotic use in combination with day-care attendance. These findings warrant more judicious use of antibiotics in children.

[Indexed for MEDLINE]

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