Antibiotic non-susceptibility among Streptococcus pneumoniae and Haemophilus influenzae isolates identified in African cohorts: a meta-analysis of three decades of published studies

Int J Antimicrob Agents. 2013 Dec;42(6):482-91. doi: 10.1016/j.ijantimicag.2013.08.012. Epub 2013 Sep 23.

Abstract

Management of community-acquired pneumonia caused by Streptococcus pneumoniae and Haemophilus influenzae type B (Hib) can be complicated by emerging antimicrobial non-susceptibility. We conducted a meta-analysis to examine the antibiotic susceptibility of community-acquired invasive infections with S. pneumoniae and Hib in Africa from 1978 to 2011. With the notable exceptions of widespread trimethoprim/sulfamethoxazole (SXT) and tetracycline non-susceptibility, the majority of pneumococci remain susceptible to ampicillin/amoxicillin. However, 23.8% of pneumococcal meningitis isolates are non-susceptible to penicillin. Similarly, Hib isolates show non-susceptibility to SXT, tetracycline, erythromycin and chloramphenicol. β-Lactamase production among Hib isolates is increasing, a new observation for Africa, but is mitigated somewhat by Hib vaccination scale-up. In summary, pneumococcal susceptibility to amoxicillin remains high throughout Africa, and amoxicillin can be effectively and safely used as first-line treatment for childhood pneumonia. Data support first-line treatment of bacterial meningitis with ceftriaxone or cefotaxime.

Keywords: Africa; Antibiotic non-susceptibility; Haemophilus influenzae; Pneumonia; Streptococcus pneumoniae.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Africa
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology*
  • Drug Resistance, Bacterial*
  • Haemophilus Infections / drug therapy
  • Haemophilus Infections / microbiology*
  • Haemophilus influenzae / drug effects*
  • Haemophilus influenzae / isolation & purification
  • Humans
  • Microbial Sensitivity Tests
  • Pneumococcal Infections / drug therapy
  • Pneumococcal Infections / microbiology*
  • Streptococcus pneumoniae / drug effects*
  • Streptococcus pneumoniae / isolation & purification

Substances

  • Anti-Bacterial Agents