[Penicillin-resistant Streptococcus pneumoniae infections: current trends in epidemiology and antibiotic chemotherapy].

The world-wide emergence of penicillin-resistant Streptococcus pneumoniae has led to dilemmas in the management of pneumococcal infections. Furthermore, most penicillin-resistant pneumococci are simultaneously resistant to a wide variety of other antibiotics, including cephalosporins, macrolides and tetracyclines. Epidemiological surveys in Japan demonstrated that 30-50% of clinical isolates were penicillin-insusceptible(MIC: > or = 0.125 microgram/ml). At present time most penicillin-resistant pneumococcal pneumonia cases are well treated with penicillin or cephalosporin, but significant numbers of treatment failures were reported in meningitis patients. Data from healthy mice model of pneumonia clearly showed that carbapenems and vancomycin are more active than cefotaxime or penicillin in high dose. Careful and continuous surveys for trends in antibiotic resistance and clinical impacts of antibiotic-resistant pneumococci are warranted.