Penicillin tolerance in beta-streptococci isolated from patients with tonsillitis.

Beta-streptococci isolated from patients with acute tonsillitis were tested for penicillin tolerance defined as an MBC/MIC ratio greater than or equal to 16. 11/18 strains recovered from patients with clinical treatment failure were tolerant to penicillin in comparison with 0/15 strains from successfully treated patients. The MBC/MIC ratio was less than 16 for all strains versus cefadroxil but above that ratio for many strains versus clindamycin, doxycycline and erythromycin. We suggest that penicillin tolerance may be one reason to treatment failures in individuals with streptococcal tonsillitis and that other antibiotics could be used to treat these patients since penicillin tolerance is not correlated to a general increase in antibiotic resistance.

[1]  Dm Jones.  Recent Advances in Streptococci and Streptococcal Diseases , 1986 .

[2]  E. Kaplan,et al.  Association of penicillin tolerance with failure to eradicate group A streptococci from patients with pharyngitis. , 1985, The Journal of pediatrics.

[3]  G. Slater,et al.  Detection of penicillin tolerance in streptococci. , 1983, Journal of clinical pathology.

[4]  K. Kim,et al.  Use of penicillin-gradient and replicate plates for the demonstration of tolerance to penicillin in streptococci. , 1983, The Journal of infectious diseases.

[5]  D. Durack,et al.  Therapeutic significance of penicillin tolerance in experimental streptococcal endocarditis , 1983, Antimicrobial Agents and Chemotherapy.

[6]  J. Dankert,et al.  Screening for penicillin tolerance in viridans streptococci by a simple disk method , 1982, Journal of clinical microbiology.

[7]  A. Tomasz,et al.  Penicillin-resistant and penicillin-tolerant mutants of group A Streptococci , 1982, Antimicrobial Agents and Chemotherapy.

[8]  K. Kim,et al.  Penicillin tolerance in group B streptococci isolated from infected neonates. , 1981, The Journal of infectious diseases.

[9]  D. Agarwal,et al.  Aldehyde Dehydrogenase Deficiency as Cause of Facial Flushing Reaction to Alcohol in Japanese , 1995, Alcohol health and research world.

[10]  G. Richards,et al.  Penicillin tolerance of human isolates of group C streptococci , 1981, Antimicrobial Agents and Chemotherapy.

[11]  M. Tenenbaum,et al.  ANTIMICROBIAL TOLERANCE IN GROUP G STREPTOCOCCI , 1980, The Lancet.

[12]  H. Miles,et al.  PENICILLIN TOLERANCE IN STREPTOCOCCUS FÆCALIS , 1980, The Lancet.

[13]  J. Dankert,et al.  PENICILLIN TOLERANCE AND BACTERIAL ENDOCARDITIS , 1980, The Lancet.

[14]  M. Laverdière,et al.  A NEW TYPE OF PENICILLIN RESISTANCE OF STAPHYLOCOCCUS AUREUS , 1977, The Lancet.

[15]  H. Feldman.  Streptococci and Streptococcal Diseases: Recognition, Understanding and Management , 1973 .

[16]  G. Kahlmeter,et al.  New Method for the Serological Grouping of Streptococci with Specific Antibodies Adsorbed to Protein A-Containing Staphylococci , 1973, Infection and immunity.

[17]  A. Tomasz,et al.  Multiple Antibiotic Resistance in a Bacterium with Suppressed Autolytic System , 1970, Nature.

[18]  H. Eagle,et al.  THE RATE OF BACTERICIDAL ACTION OF PENICILLIN IN VITRO AS A FUNCTION OF ITS CONCENTRATION, AND ITS PARADOXICALLY REDUCED ACTIVITY AT HIGH CONCENTRATIONS AGAINST CERTAIN ORGANISMS , 1948, The Journal of experimental medicine.

[19]  K. Roos.  The diagnostic value of symptoms and signs in acute tonsillitis in children over the age of 10 and in adults. , 1985, Scandinavian journal of infectious diseases.

[20]  S. Holm,et al.  Treatment failure in acute streptococcal tonsillitis in children over the age of 10 and in adults. , 1985, Scandinavian journal of infectious diseases.

[21]  A. Tomasz,et al.  The mechanism of the irreversible antimicrobial effects of penicillins: how the beta-lactam antibiotics kill and lyse bacteria. , 1979, Annual review of microbiology.