Decline of Erythromycin Resistance of Group A β-Hemolytic Streptococci in Japan

Abstract

Objective: To determine the current prevalence of erythromycin resistance and penicillin tolerance of group A β-hemolytic streptococci (GABHS) in Japan. Research Design: One hundred four isolates of GABHS from the civilian community in Tokyo and 101 isolates from the military population at the US Air Force Base in Yokota, Japan, were tested for erythromycin susceptibility and penicillin susceptibility and tolerance. Setting: US Army Medical Center. Results: Of the Japanese civilian isolates, two were moderately susceptible and none were resistant to erythromycin; of the military isolates, none were moderately susceptible and one was resistant, for an overall resistance rate of 0.49%. All isolates were exquisitely susceptible to penicillin, and no evidence of penicillin tolerance was found. Conclusions: Comparison with similar studies worldwide shows that erythromycin susceptibility of GABHS in Japan is now among the lowest in the world, while just over a decade ago it was the highest. These observations mandate constant monitoring of erythromycin resistance of GABHS wherever this drug is used to treat patients with infections due to this organism. (Arch Pediatr Adolesc Med. 1994;148:67-71)