Antibiotic resistance of Staphylococcus aureus in a burns unit after stopping routine prophylaxis with erythromycin

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Abstract
After the withdrawal of routine prophylaxis by erythromycin in a burns unit there was a large fall in the proportion of erythromycin-resistant Staphylococcus aureus isolated from burns, and a parallel fall in the proportion of staphylococci resistant to methicillin, novobiocin, lincomycin, tetracycline, kanamycin and cephaloridine. Treatment of several patients with erythromycin during two small outbreaks of Streptococcus pyogenes infection was associated, in the first period, with a parallel increase in the proportions of Staph. aureus from burns which were resistant to erythromycin and to the other antibiotics mentioned above, followed by a parallel fall in multi-resistance when erythromycin was no longer being used, and in the second period with a temporary increase in resistance to tetracycline and erythromycin only. In a third period, an increased use of penicillin was associated with a small increase in multi-resistant staphylococci. Fluctuations in resistance to novobiocin were apparently due to variable use of other antibiotics (especially erythromycin), since novobiocin had not been used in the Unit for some years.

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