Macrolide resistance in streptococcal pharyngitis

Many previous studies have shown that the rate of resistance to a specific antibiotic is proportionally related to its use. The rate of prescription of azithromycin in New Brunswick is 2-3 times the Canadian mean, according to IMS Canada data made available to us by the Canadian Integrated Program for Antimicrobial Resistance Surveillance of the Public Health Agency of Canada through their antibiotic use database. This underlines the importance of following well-known but unfortunately neglected antibiotic guidelines. First, antibiotics should be prescribed only to treat obvious bacterial infections and only when an antigen-detection test or a culture or both are positive. second, macrolides are considered to be a third-line therapy for streptococcal pharyngitis and their use should be limited accordingly.