Trends of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae in Europe

Nienke Bruinsma, Karl G. Kristinsson, Stef Bronzwaer, Paul Schrijnemakers, John Degener, Edine Tiemersma, Waleria Hryniewicz, Jos Monen, Hajo Grundmann, H. Mittermayer, W. Koller, H. Goossens, E. Hendrickx, B. Markova, S. Kalenic, A. Tambic-Andrasevic, P. Urbaskova, D. Monnet, P. Naaber, O. LyytikäinenA. Nissinen, H. Aubry-Damon, P. Courvalin, U. Buchholz, W. Witte, N. Legakis, G. Vatopoulos, M. Füzi, D. O'Flanagan, O. Murphy, R. Raz, H. Edelstein, G. Cornaglia, P. D'Ancona, R. Hemmer, M. Borg, A. de Neeling, A. Hoiby, E. Bjørløw, M. Caniça, I. Codita, M. Gubina, J. Kolman, L. Langsadl, F. Baquero, J. Campos, B. Liljequist, A. Johnson, M. Wale

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Objectives: To forecast trends in resistance to penicillin and erythromycin among Streptococcus pneumoniae in Europe. Methods: Since 1999, the European Antimicrobial Resistance Surveillance System (EARSS) has collected routine antimicrobial susceptibility test results of S. pneumoniae. To observe and predict changes of reduced susceptibility over time, we used a multinomial logistic regression model. Results: Large variations in penicillin and erythromycin non-susceptibility were observed between countries, and reduced susceptibility to erythromycin (17%) has become more frequent than reduced susceptibility to penicillin (10%) in Europe overall. An overall decrease in single penicillin non-susceptibility, but an increase in dual non-susceptibility was observed, indicating a shift of single penicillin to combined non-susceptibility with erythromycin. By 2006, the proportion of single erythromycin and dual non-susceptibility could increase to as much as 20.4% and 8.9%, respectively. Conclusions: Our results indicate that appropriately dosed β-lactams for empirical therapy are still the treatment of choice, and that macrolides should be used with prudence.

Original languageEnglish
Pages (from-to)1045-1050
Number of pages6
JournalJournal of Antimicrobial Chemotherapy
Issue number6
Publication statusPublished - Dec 1 2004



  • Antimacrobial use
  • Antimicrobial resistance
  • Public health

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Bruinsma, N., Kristinsson, K. G., Bronzwaer, S., Schrijnemakers, P., Degener, J., Tiemersma, E., Hryniewicz, W., Monen, J., Grundmann, H., Mittermayer, H., Koller, W., Goossens, H., Hendrickx, E., Markova, B., Kalenic, S., Tambic-Andrasevic, A., Urbaskova, P., Monnet, D., Naaber, P., ... Wale, M. (2004). Trends of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae in Europe. Journal of Antimicrobial Chemotherapy, 54(6), 1045-1050.