Abstract
Community-acquired respiratory tract infections (RTIs) account for a substantial proportion of outpatient antimicrobial drug prescriptions worldwide. Concern over the emergence of multidrug resistance in pneumococci has largely been focused on penicillin-resistant Streptococcus pneumoniae. Macrolide antimicrobial drugs have been widely used to empirically treat community-acquired RTIs because of their efficacy in treating both common and atypical respiratory pathogens, including S. pneumoniae. However, increased macrolide use has been associated with a global increase in pneumococcal resistance, which is leading to concern over the continued clinical efficacy of the macrolides to treat community-acquired RTIs. We provide an overview of macrolide-resistant S. pneumoniae and assess the impact of this resistance on the empiric treatment of community-acquired RTIs.
Highlights
The World Health Report 2004 – Changing History, published by the World Health Organization, calls for a comprehensive human immunodeficiency virus (HIV)/AIDS strategy that links prevention, treatment, care and long-term support
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries
Most of the increased funding is for the fight against HIV/AIDS
Summary
Sex and mortality stratum in WHO regions, estimates for 2002 Annex Table 3 Burden of disease in DALYs by cause, sex and mortality stratum in WHO regions, estimates for 2002 Annex Table 4 Healthy life expectancy (HALE) in all WHO Member States, estimates for 2002 Annex Table 5 Selected national health accounts indicators: measured levels of expenditure on health, 1997–2001 Annex Table 6 Selected national health accounts indicators: measured levels of per capita expenditure on health, 1997–2001 Annex Table 7 Millennium Development Goals: selected health indicators in all WHO Member States, 2000 (unless specified). The responsibility of WHO and its partners in this effort is to ensure that the increased funding is used in such a way as to enable countries to fight HIV/AIDS and at the same time strengthen their health systems. The World Health Report 2004 shows how projects like this can bring the medical treatment that saved Joseph Jeune to millions of other people in poor and middle-income countries and how, crucially, such efforts can drive improvements in health systems. In September 2003, WHO, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Global Fund declared lack of access to AIDS treatment with antiretroviral medicines a global health emergency These organizations and their partners launched an effort to provide 3 million people in developing countries with antiretroviral therapy by the end of 2005 – the 3 by 5 initiative, one of the most ambitious public health projects ever conceived
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