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Effect of High-Dose Amoxicillin on the Prevalence of Penicillin-Resistant Streptococcus pneumoniae in Rural Alaska

Thomas W. Hennessy, MD, MPH; Dana Bruden, MS; Kenneth M. Petersen, MD; Alan J. Parkinson, PhD; Debby Hurlburt, RN; Marilyn Getty, RN, FNP; Jay C. Butler, MD; Benjamin Schwartz, MD
JAMA. 2002;287(16):2078-2079. doi:10.1001/jama.287.16.2073.
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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.

Schrag  SJPena  ChFernandez  J  et al.  Effect of short-course, high-dose amoxicillin therapy on resistant pneumococcal carriage. JAMA. 2001;286:49-56.
Murray  PRBaron  EJPfaller  MATenover  FCYolken  RH Manual of Clinical Microbiology. 7th ed. Washington, DC: American Society for Microbiology; 1999.
Hennessy  TWPetersen  KMBruden  D  et al.  Changes in antibiotic prescribing practices and carriage of penicillin-resistant Streptococcus pneumoniae: a controlled intervention trial in rural Alaska. Clin Infect Dis. In press.
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Figure. Proportion of Nasopharyngeal Streptococcus pneumoniae Nonsusceptible or Resistant to Penicillin Before and After Increased Amoxicillin Dose Intervention, Alaska, 1998-1999
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