Penicillin tolerance and erythromycin resistance of group A beta-hemolytic streptococci in Hawaii and the Philippines
R. R. Wittler, S. M. Yamada, J. W. Bass, R. Hamill, R. A. Wiebe and D. P. Ascher
Department of Pediatrics, Tripler Army Medical Center, Honolulu, Hawaii 96859-5000.
Penicillin remains the drug of choice for the treatment of streptococcal
pharyngitis, with erythromycin as an alternative drug for individuals who
cannot take penicillin. Two areas of concern in the management of
streptococcal pharyngitis are (1) the prevalence of penicillin-tolerant
group A beta-hemolytic streptococci reported in recent studies and (2) the
high prevalence of erythromycin resistance in some geographic areas. We
tested 305 isolates of group A beta-hemolytic streptococci from Hawaii and
the Philippines for penicillin minimum inhibitory concentrations and
minimum bactericidal concentrations and erythromycin minimum inhibitory
concentrations. There was no evidence of penicillin resistance or
tolerance. The prevalence of erythromycin-resistant and moderately
susceptible isolates was 3.6% and 2.3%, respectively. There was a trend
toward greater erythromycin resistance levels among Hawaiian isolates, but
this was not statistically significant.
