Dermatology

Abstract

Erythromycin resistance to group A streptococci is a serious clinical problem because there are few alternative oral therapies for the treatment of streptococcal infections in patients who are allergic to penicillins and cephalosporins. In Finland between 1979 and 1989, as the use of erythromycin was nearly tripling, an unusually high frequency of such resistance was noted in one geographic region. A national study of 272 isolates of group A streptococci obtained from blood cultures, 3087 consecutive isolates from throat swabs, and 1349 isolates from skin swabs revealed that the frequency of resistance to erythromycin had increased in blood cultures from 4% in 1988 to 24% in 1990, in throat swabs from 7% in 1988 to 20% in 1990, and in skin swabs from 11% in 1988 to 31% in 1990. This rapid and substantial increase in resistance to erythromycin in group A streptococci and the failure of erythromycin treatment to