Pharyngeal colonization prevalence rates for Streptococcus pyogenes and Streptococcus pneumoniae in a respiratory chemoprophylaxis intervention study using azithromycin

被引:18
作者
Putnam, SD [1 ]
Gray, GC
Biedenbach, DJ
Jones, RN
机构
[1] Univ Iowa, Dept Prevent Med & Environm Hlth, Iowa City, IA 52241 USA
[2] Univ Iowa, Dept Pathol, Iowa City, IA 52241 USA
[3] USN, Hlth Res Ctr, San Diego, CA 92152 USA
关键词
streptococcal colonization; azithromycin;
D O I
10.1046/j.1469-0691.2000.00001.x
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives A prospective assessment of the pharyngeal colonization prevalence rate for Streptococcus pyrogenes and. Streptococcus pneumoniae before and after an azithromycin chemoprophylaxis intervention clinical trial in a cohort of US Marine Corps trainees, In addition, the minimum inhibitory concentrations (MICs) for all streptococcal isolates, for azithromycin. penicillin, erythromycin and cefotaxime are reported. Methods Between November 1994 and March 1995, 1108 asymptomatic male US Marine Corps trainees, located in Southern California, were randomly assigned to one of three intervention groups: (1) weekly oral azithromycin, 500 mg (n = 362); (2) 1.2 MU benzathine penicillin G, intramuscularly once (n = 374); or (3) no chemoprophylaxis (n = 372). Subjects provided both a pre- and post-training pharyngeal culture and microbial analysis was conducted to determine the colonization status of each study subject. Results The pretraining colonization prevalence was 1.2%:, for S, pneumoniae and 2.4% for S. pyogenes There was no statistical difference in pretraining prevalence between the three treatment groups for either organism. Post-training pharyngeal cultures revealed an overall prevalence of 1.1% with no difference between treatment arms. However, the overall post-training prevalence of S. pyogenes colonization increased to 4.8%, with the azithromycin group having significant evidence of protection (0.7%) in comparison with the no-treatment group (8.2%). The Etest method demonstrated no significant difference in the MIC50, MIC90, and MIC ranges between pre- and post-training isolates for any of the tested drugs. Conclusion The use of azithromycin as a chemoprophylactic agent to reduce the colonization and subsequent infection of streptococcal respiratory disease among healthy adult male military recruits may be beneficial.
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页码:2 / 8
页数:7
相关论文
共 17 条
[1]   IN-VITRO ACTIVITY OF AZITHROMYCIN (CP-62,993) AGAINST CHLAMYDIA-TRACHOMATIS AND CHLAMYDIA-PNEUMONIAE [J].
AGACFIDAN, A ;
MONCADA, J ;
SCHACHTER, J .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1993, 37 (09) :1746-1748
[2]   Emerging resistance to antimicrobial agents in gram-positive bacteria - Pneumococci [J].
Appelbaum, PC .
DRUGS, 1996, 51 :1-5
[4]   PROPHYLAXIS OF STREPTOCOCCAL BACTEREMIA WITH ORAL PENICILLIN-V IN CHILDREN UNDERGOING BONE-MARROW TRANSPLANTATION [J].
CASTAGNOLA, E ;
LANINO, E ;
GARAVENTA, A ;
DINI, G ;
DALLORSO, S ;
CARREGA, G ;
VISCOLI, C .
SUPPORTIVE CARE IN CANCER, 1995, 3 (05) :319-321
[5]   ORAL ERYTHROMYCIN PROPHYLAXIS AGAINST STREPTOCOCCUS-PYOGENES INFECTION IN PENICILLIN-ALLERGIC MILITARY RECRUITS - A RANDOMIZED CLINICAL-TRIAL [J].
FUJIKAWA, J ;
STRUEWING, JP ;
HYAMS, KC ;
KAPLAN, EL ;
TUPPONCE, AK ;
GRAY, GC .
JOURNAL OF INFECTIOUS DISEASES, 1992, 166 (01) :162-165
[6]   Weekly oral azithromycin as prophylaxis for agents causing acute respiratory disease [J].
Gray, GC ;
McPhate, DC ;
Leinonen, M ;
Cassell, GH ;
Deperalta, EP ;
Putnam, SD ;
Karcher, JA ;
Sawyer, MH ;
Laurila, A ;
Connor, JD .
CLINICAL INFECTIOUS DISEASES, 1998, 26 (01) :103-110
[7]   Respiratory diseases among US military personnel: Countering emerging threats [J].
Gray, GC ;
Callahan, JD ;
Hawksworth, AW ;
Fisher, CA ;
Gaydos, JC .
EMERGING INFECTIOUS DISEASES, 1999, 5 (03) :379-387
[8]   HYPERENDEMIC STREPTOCOCCUS-PYOGENES INFECTION DESPITE PROPHYLAXIS WITH PENICILLIN-G BENZATHINE [J].
GRAY, GC ;
ESCAMILLA, J ;
HYAMS, KC ;
STRUEWING, JP ;
KAPLAN, EL ;
TUPPONCE, AK .
NEW ENGLAND JOURNAL OF MEDICINE, 1991, 325 (02) :92-97
[9]  
Gray GC., 1995, FED PRACT, V12, P27
[10]   IN-VITRO AND IN-VIVO ACTIVITIES OF MACROLIDES AGAINST MYCOPLASMA-PNEUMONIAE [J].
ISHIDA, K ;
KAKU, M ;
IRIFUNE, K ;
MIZUKANE, R ;
TAKEMURA, H ;
YOSHIDA, R ;
TANAKA, H ;
USUI, T ;
SUYAMA, N ;
TOMONO, K ;
KOGA, H ;
KOHNO, S ;
IZUMIKAWA, K ;
HARA, K .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1994, 38 (04) :790-798