Pneumococcal resistance patterns in Europe.

The emergence of Streptococcus pneumoniae strains with decreased susceptibility to penicillin has been reported worldwide over the past 20 years. However, there are striking discrepancies in penicillin susceptibility among various European countries, suggesting that local conditions may affect clonal propagation or de novo selection of resistant strains. In the present study, data on penicillin resistance patterns, antibiotic use and mode of administration, and treatment compliance in five European countries (France, Spain, Germany, Italy, and the UK) were compared. High prevalence rates of penicillin-resistant pneumococci have been reported in Spain and France, where antibiotics are widely prescribed, and overall in Europe, patient compliance with more than 50% of oral antimicrobial prescriptions is inadequate. The low prevalence of penicillin resistance in Germany and the UK coincides with lower antibiotic consumption and better treatment compliance in these countries. Recent attempts to raise public awareness and to restrict and improve indications for antimicrobial agents have resulted in decreased pneumococcal resistance in Hungary and Iceland, suggesting that pneumococcal resistance can be reversed.