A review of antibiotic resistance patterns of Streptococcus pneumoniae in Europe.

Streptococcus pneumoniae no longer has predictable antibiotic susceptibility. There are two areas of high prevalence of resistance (over 25%) to beta-lactam antibiotics in the South-West and North-East of Europe. In Spain, a close relationship has been found between the yearly rate of aminopenicillin consumption and penicillin resistance. High level resistance (MIC greater than or equal to 1 mg/L) has developed against a previous background of low level resistance. The serotypes involved in penicillin resistance in Spain are widespread in other countries. Macrolide resistance is high in France (over 15%) and is also increasing in other countries. All these resistant isolates remain susceptible to the most recent fluoroquinolones, such as temafloxacin. Prospective surveillance, more rational use of antibiotics and a diversification of antibiotic use in respiratory tract infections may serve to limit the threat of antibiotic resistance in S. pneumoniae.