The resistance of Streptococcus pneumoniae to penicillin and other antimicrobial agents is increasing in many parts of the world. The frequency of erythromycin resistance in parts of Europe1 and, to a lesser extent, in the United States2 limits the usefulness of macrolide antibiotics for the treatment of pneumonia, and resistance to trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline is an important problem in some other countries3,4. Recently, resistance to and clinical failure of the extended-spectrum cephalosporins ceftriaxone and cefotaxime in the treatment of pneumococcal meningitis have been noted in Spain5,6 and the United States7,8. In addition, there have.
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