Increased carriage of trimethoprim/sulfamethoxazole-resistant Streptococcus pneumoniae in Malawian children after treatment for malaria with sulfadoxine/pyrimethamine

Daniel R. Feikin, Scott F. Dowell, Okey C. Nwanyanwu, Keith P. Klugman, Peter N. Kazembe, Lawrence M. Barat, Cristel Graf, Peter B. Bloland, Charles Ziba, Robin E. Huebner, Ben Schwartz

Research output: Contribution to journalArticle

Abstract

Treatment of malaria with sulfadoxine/pyrimethamine and of presumed bacterial infections with trimethoprim/sulfamethoxazole (cotrimoxazole) was assessed to see if either increases the carriage of cotrimoxazole-resistant Streptococcus pneumoniae in Malawian children. Children <5 years old treated with sulfadoxine/pyrimethamine, cotrimoxazole, or no antimicrobial agent were enrolled in a prospective observational study. Nasopharyngeal swabs were taken before treatment and 1 and 4 weeks later. Pneumococci were tested for antibiotic susceptibility by broth microdilution. In sulfadoxine/pyrimethamine-treated children, the proportion colonized with cotrimoxazole-nonsusceptible pneumococci increased from 38.1% at the initial visit to 44.1% at the 4-week follow-up visit (P = .048). For cotrimoxazole- treated children, the proportion colonized with cotrimoxazole-nonsusceptible pneumococci increased from 41.5% at the initial visit to 52% at the 1-week follow-up visit (P = .0017) and returned to 41.7% at the 4-week follow-up. Expanding use of sulfadoxine/pyrimethamine to treat chloroquine-resistant malaria may have implications for national pneumonia programs in developing countries where cotrimoxazole is widely used.

Original languageEnglish (US)
Pages (from-to)1501-1505
Number of pages5
JournalJournal of Infectious Diseases
Volume181
Issue number4
DOIs
StatePublished - May 22 2000
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Feikin, D. R., Dowell, S. F., Nwanyanwu, O. C., Klugman, K. P., Kazembe, P. N., Barat, L. M., Graf, C., Bloland, P. B., Ziba, C., Huebner, R. E., & Schwartz, B. (2000). Increased carriage of trimethoprim/sulfamethoxazole-resistant Streptococcus pneumoniae in Malawian children after treatment for malaria with sulfadoxine/pyrimethamine. Journal of Infectious Diseases, 181(4), 1501-1505. https://doi.org/10.1086/315382