antibiotic selection pressure and macrolide resistance in nasopharyngeal streptococcus pneumoniae a cluster-randomized clinical trial耐抗生素选择压力和大环内酯物鼻咽癌肺炎链球菌集群随机临床试验.pdfVIP

Antibiotic Selection Pressure and Macrolide Resistance in Nasopharyngeal Streptococcus pneumoniae: A Cluster- Randomized Clinical Trial 1,2 1 3 3 1 Alison H. Skalet , Vicky Cevallos , Berhan Ayele , Teshome Gebre , Zhaoxia Zhou , James H. 4 3 3 5 6 1,2 Jorgensen , Mulat Zerihun , Dereje Habte , Yared Assefa , Paul M. Emerson , Bruce D. Gaynor , Travis C. Porco1,2,7, Thomas M. Lietman1,2,7,8, Jeremy D. Keenan1,2* 1 Francis I. Proctor Foundation for Research in Opthalmology, University of California, San Francisco, San Francisco, California, United States of America, 2 Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America, 3 The Carter Center, Addis Ababa, Ethiopia, 4 University of Texas Health Sciences Center, San Antonio, Texas, United States of America, 5 Department of Ophthalmology, University of Gondar, Ethiopia, 6 The Carter Center, Atlanta, Georgia, United States of America, 7 Department of Epidemiology Biostatistics, University of California, San Francisco, San Francisco, California, United States of America, 8 Institute for Global Health, University of California, San Francisco, San Francisco, California, United States of America Abstract Background: It is widely thought that widespread antibiotic use selects for community antibiotic resistance, though this has been difficult to prove in the setting of a community-randomized clinical trial. In this study, we used a randomized clinical trial design to assess whether macrolide resistance was higher in communities treated with mass azithromycin for tra