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Correspondence
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Volume 346:1916 June 13, 2002 Number 24
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Pneumonia in Children

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by McIntosh, K.
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To the Editor: In his review article (Feb. 7 issue),1 McIntosh states that "a macrolide antibiotic is the most reasonable first choice" to treat pneumonia in children who are 5 to 15 years old. We disagree. In the past few decades, antibiotic activity against Streptococcus pneumoniae has changed. Macrolides have become less effective2 because of an increasing rate of resistance to these agents. In the northeastern region of Italy, pneumococci are resistant to macrolides in close to 50 percent of the cases of infection. Given that the most frequent causal agent is S. pneumoniae and that amoxicillin is still effective . . . [Full Text of this Article]

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