Antimicrobial Drug Use and Macrolide-Resistant Streptococcus pyogenes, Belgium

Abstract

In Belgium, decreasing macrolide, lincosamide, streptogramins B, and tetracycline use during 1997–2007 correlated significantly with decreasing macrolide-resistant Streptococcus pyogenes during 1999–2009. Maintaining drug use below a critical threshold corresponded with low-level macrolide-resistant S. pyogenes and an increased number of erm(A)-harboring emm77 S. pyogenes with low fitness costs.

Keywords

• Group A streptococcus
• antibiotic resistance
• fitness costs
• macrolide use
• macrolides
• erm(A)