Antibiotic non-susceptibility among Streptococcus pneumoniae and Haemophilus influenzae isolates identified in African cohorts: a meta-analysis of three decades of published studies.

Abstract	Management of community-acquired pneumonia caused by Streptococcus pneumoniae and Haemophilus influenzae type B (Hib) can be complicated by emerging antimicrobial non-susceptibility. We conducted a meta-analysis to examine the antibiotic susceptibility of community-acquired invasive infections with S. pneumoniae and Hib in Africa from 1978 to 2011. With the notable exceptions of widespread trimethoprim/sulfamethoxazole (SXT) and tetracycline non-susceptibility, the majority of pneumococci remain susceptible to ampicillin/amoxicillin. However, 23.8% of pneumococcal meningitis isolates are non-susceptible to penicillin. Similarly, Hib isolates show non-susceptibility to SXT, tetracycline, erythromycin and chloramphenicol. β-Lactamase production among Hib isolates is increasing, a new observation for Africa, but is mitigated somewhat by Hib vaccination scale-up. In summary, pneumococcal susceptibility to amoxicillin remains high throughout Africa, and amoxicillin can be effectively and safely used as first-line treatment for childhood pneumonia. Data support first-line treatment of bacterial meningitis with ceftriaxone or cefotaxime.
Authors	Amy Sarah Ginsburg, Laura Tinkham, Katherine Riley, Noa A Kay, Keith P Klugman, Christopher J Gill
Journal	International journal of antimicrobial agents (Int J Antimicrob Agents) Vol. 42 Issue 6 Pg. 482-91 (Dec 2013) ISSN: 1872-7913 [Electronic] Netherlands
PMID	24139883 (Publication Type: Journal Article, Meta-Analysis, Review)
Copyright	Copyright © 2013 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
Chemical References	Anti-Bacterial Agents
Topics	Africa Anti-Bacterial Agents (pharmacology, therapeutic use) Community-Acquired Infections (drug therapy, microbiology) Drug Resistance, Bacterial Haemophilus Infections (drug therapy, microbiology) Haemophilus influenzae (drug effects, isolation & purification) Humans Microbial Sensitivity Tests Pneumococcal Infections (drug therapy, microbiology) Streptococcus pneumoniae (drug effects, isolation & purification)

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