Global and local variations in antimicrobial susceptibilities and resistance development in the major respiratory pathogens.

Acute respiratory tract infections, such as bacterial pneumonia and acute exacerbations of chronic bronchitis, have been identified by the World Health Organisation as the leading global infectious cause of death. An increasing prevalence of antibiotic resistance has been identified worldwide in the three major bacterial respiratory pathogens -Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae. The selection and spread of resistance is to some degree inevitable and the importance of monitoring its progress has led to the instigation of numerous international, regional and national surveillance programmes. The results from surveillance studies show wide variations in susceptibility rates, both geographically and over time, highlighting the need for local resistance prevalence data in order to guide empirical prescribing and to identify areas in which medical need for new agents is greatest.