Volume 12, Number 8—August 2006
Research
Macrolide Resistance in Adults with Bacteremic Pneumococcal Pneumonia
Joshua P. Metlay*†
, Neil O. Fishman†, Marshall M. Joffe†, Michael J. Kallan†, Jesse L. Chittams†, and Paul H. Edelstein†
, Neil O. Fishman†, Marshall M. Joffe†, Michael J. Kallan†, Jesse L. Chittams†, and Paul H. Edelstein†Table 2
Patterns of prior antimicrobial drug exposure for patients and controls*
| Antimicrobial agent exposure | Macrolide resistant, n = 76 (%) | Macrolide susceptible, n = 368 (%) | OR | 95% CI | p value |
|---|---|---|---|---|---|
| Any in prior 6 mo† | 34 (45) | 101 (27) | 2.2 | 1.3–3.7 | 0.002 |
| Any macrolide in prior 6 mo | 14 (19) | 29 (8) | 2.7 | 1.3–5.4 | 0.004 |
| Any quinolone in prior 6 mo | 14 (19) | 33 (9) | 2.3 | 1.2–4.6 | 0.013 |
| Any penicillin in prior 6 mo | 8 (11) | 36 (10) | 1.1 | 0.5–2.5 | 0.81 |
| Any cephalosporin in prior 6 mo | 4 (5) | 15 (4) | 1.3 | 0.4–4.1 | 0.62 |
| Any tetracycline in prior 6 mo | 1 (1) | 3 (1) | 1.6 | 0.2–16.1 | 0.66 |
| No. antimicrobial agents in 6 mo | |||||
| None | 41 (55) | 261 (71) | Referent | ||
| 1 prescription | 18 (24) | 75 (20) | 1.5 | 0.8–2.7 | 0.20 |
| >2 prescriptions | 16 (21) | 33 (9) | 3.0 | 1.5–6.0 | 0.002 |
| Did not complete last prescription | 9 (12) | 14 (4) | 3.5 | 1.4–8.3 | 0.004 |
| On antimicrobial agent at admission | 4 (5) | 7 (2) | 2.9 | 0.8–10.2 | 0.083 |
| Time since antimicrobial agent‡ | |||||
| No prior drug use | 44 (59) | 277 (75) | Referent | ||
| <3 mo | 22 (29) | 62 (17) | 2.2 | 1.2–4.2 | 0.006 |
| 4–6 mo | 9 (12) | 30 (8) | 1.7 | 0.8–4.5 | 0.12 |
*Odds ratio (OR) and 95% binomial confidence interval (95% CI). P value based on χ2 test.
†Does not include antimicrobial agents that patient was taking at time of admission for bacteremic pneumococcal pneumonia.
‡For patients on >1 antimicrobial agent in previous 6 months, this represents time since most recent course of drugs.
