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To the Editor: Schrag et al¹ recently found that short-course, high-dose amoxicillin therapy could decrease the rate of carriage of penicillin-nonsusceptible Streptococcus pneumoniae (PNSP) 28 days after treatment. We sought to determine whether an increased dosage of amoxicillin for treatment of children can reduce community-wide carriage of PNSP in a remote rural area.

Methods

To assess baseline PNSP carriage, in spring 1998 we invited residents of all ages in 12 remote Alaskan villages (total population, 4621; 94% Alaska Natives) to provide nasopharyngeal swabs. Swabs were directly plated and cultured using standard methods.^2-3 Penicillin susceptibility was measured by E test (AB Biodisk, Solna, Sweden); isolates were classified as susceptible (minimum inhibitory concentration [MIC] 0.064 µg/mL), intermediate (MIC >0.064 µg/mL and 1.0 µg/mL), and resistant (MIC >1.0 µg/mL). PNSP was defined as isolates having an MIC greater than 0.064 µg/mL.

Starting in October 1998, for 4 villages the standard 10-day amoxicillin dosage used . . . [Full Text of this Article]

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RELATED ARTICLE

Effect of Short-Course, High-Dose Amoxicillin Therapy on Resistant Pneumococcal Carriage: A Randomized Trial
Stephanie J. Schrag, Chabela Peña, Josefina Fernández, Jacqueline Sánchez, Virgen Gómez, Eddy Pérez, Jesús M. Feris, and Richard E. Besser
JAMA. 2001;286(1):49-56.
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