Comparison of the Respiratory Resistomes and Microbiota in Children Receiving Short versus Standard Course Treatment for Community-Acquired Pneumonia
Melinda M. Pettigrew, Jiye Kwon, Janneane F. Gent, Yong Kong, Martina Wade, Derek J. Williams, C. Buddy Creech, Scott Evans, Qing Pan, Emmanuel B. Walter, Judith M. Martin, Jeffrey S. Gerber, Jason G. Newland, Meghan E. Hofto, Mary Allen Staat, Vance G. Fowler, Henry F. Chambers, W. Charles Huskins
Abstract
Antibiotic resistance is a major threat to public health. Treatment strategies involving shorter antibiotic courses have been proposed as a strategy to lower the potential for antibiotic resistance. We examined relationships between the duration of antibiotic treatment and its impact on resistance genes and bacteria in the respiratory microbiome using data from a randomized controlled trial of beta-lactam therapy for pediatric pneumonia. The randomized design provides reliable evidence of the effectiveness of interventions and minimizes the potential for confounding. Children receiving 5 days of therapy for pneumonia had a lower prevalence of two different types of resistance genes than did those receiving the 10-day treatment. Our data also suggest that children receiving longer durations of therapy have a greater abundance of antibiotic resistance genes for a longer period of time than do children receiving shorter durations of therapy. These data provide an additional rationale for reductions in antibiotic use.