TY - JOUR AU - Metlay, Joshua AU - Fishman, Neil AU - Joffe, Marshall AU - Kallan, Michael AU - Chittams, Jesse AU - Edelstein, Paul T1 - Macrolide Resistance in Adults with Bacteremic Pneumococcal Pneumonia T2 - Emerging Infectious Disease journal PY - 2006 VL - 12 IS - 8 SP - 1223 SN - 1080-6059 AB - We conducted a case-control study of adults with bacteremic pneumococcal pneumonia to identify factors associated with macrolide resistance. Study participants were identified through population-based surveillance in a 5-county region surrounding Philadelphia. Forty-three hospitals contributed 444 patients, who were interviewed by telephone regarding potential risk factors. In multivariable analyses, prior exposure to a macrolide antimicrobial agent (odds ratio [OR] 2.8), prior flu vaccination (OR 2.0), and Hispanic ethnicity (OR 4.1) were independently associated with an increased probability of macrolide resistance, and a history of stroke was independently associated with a decreased probability of macrolide resistance (OR 0.2). Fifty-five percent of patients with macrolide-resistant infections reported no antimicrobial drug exposure in the preceding 6 months. Among patients who reported taking antimicrobial agents in the 6 months preceding infection, failure to complete the course of prescribed drugs was associated with an increased probability of macrolide resistance (OR 3.4). KW - antibacterial agents KW - microbial drug resistance KW - Streptococcus pneumoniae KW - research KW - United States DO - 10.3201/eid1208.060017 UR - https://wwwnc.cdc.gov/eid/article/12/8/06-0017_article ER - End of Reference