PHILADELPHIA — Antimicrobial resistance to all Streptococcus pneumoniae has been estimated at 30% to 40% for products such as erythromycin and azithromycin, and rising fluoroquinolone resistance has made treating bacterial cases more difficult, according to a recent presentation at the annual meeting of the American Association of Nurse Practitioners.
“This is frightening because in my world, and in [many practitioner’s] worlds, this is the best class of antibiotic we have from a spectrum perspective,” Wendy L. Wright, MS, APRN, FNP, said in her presentation. “They have side effects, but if I need to treat particular infections, this is the best drug we have for many people on an outpatient basis.”
According to Wright, acute rhinosinusitis caused by S. pneumonaie is self-limiting in only 10% to 20% of patients and makes people the sickest when compared with other causes, including Haemophilus influenzae and Moraxella catarrhalis. These strains that cause acute rhinosinusitis should be considered for antibiotic treatment over other strains, because H. influenzae is self-limiting in 50% of cases and M. catarrhalis is self-limiting in about 90% of cases.
Although they are self-limiting in many cases, both S. pneumoniae and H. influenzae have been added to a list of WHO priority pathogens, all of which are in need of new antibiotics to address this increasing resistance.
“We need to make sure that we are treating people who need to be treated with antibiotics and that we’re using the right antibiotic,” Wright said. “We know that if we can treat people appropriately and use antibiotics judiciously, we can reduce this resistance. If we don’t, it’s been said that we’re approaching the end of the antibiotic era.” — by Katherine Bortz
Wright WL, et al. Treatment of allergic rhinitis/acute rhinosinusitis in primary & urgent care. Presented at: American Association of Nurse Practitioners National Conference; June 20-25, 2017; Philadelphia.
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