caa a22 4500 477071465 CHVBK 20180405111427.0 cr unu---uuuuu 170330e19960201xx s 000 0 eng 10.1007/BF01591482 doi (NATIONALLICENCE)springer-10.1007/BF01591482 Penicillin tolerance and treatment failure in group A streptococcal pharyngotonsillitis [Elektronische Daten] [G. van Asselt, R. Mouton, C. van Boven] Failure of treatment of group A streptococcal pharyngitis and tonsillitis is well documented. One of the possible explanations for treatment failure is penicillin tolerance in group A streptococci. Reports on the prevalence of penicillin tolerance among group A streptococci (0-100%) and the presumed relationship with therapeutic failure vary considerably. Therefore, it appears worthwhile to review pharyngotonsillitis studies, devoting special attention to the variables of MIC-MBC laboratory determinations such as inoculum preparation, composition and volume of test medium, and the criteria used to define penicillin tolerance. Alternative methods (gradient-replica plate method, β-lactamase disk test, time-kill assay, and cell-lysis assay) are discussed. It is concluded that technical factors and the definitions used influenced the reported rates of penicillin tolerance. The epidemiological data suggest that tolerance is not limited to a single streptococcal serotype. Furthermore, there is not sufficient data to support a correlation between in vitro penicillin tolerance of group A streptococci and treatment failure, either in clinical cases or in animal studies. On the other hand, evidence to exclude penicillin tolerance as a cause of treatment failure is also not available. Therefore, at present, penicillin tolerance cannot be ruled out as a cause of penicillin treatment failures. MMV Medizin Verlag GmbH Munchen, 1996 van Asselt G. Department of Medical Microbiology, Leiden University Hospital, PO Box 9600, 2300, RC Leiden, The Netherlands aut Mouton R. Department of Medical Microbiology, Leiden University Hospital, PO Box 9600, 2300, RC Leiden, The Netherlands aut van Boven C. Department of Medical Microbiology, Leiden University Hospital, PO Box 9600, 2300, RC Leiden, The Netherlands aut European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/2(1996-02-01), 107-115 0934-9723 15:2<107 1996 15 10096 https://doi.org/10.1007/BF01591482 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01591482 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- van Asselt G. Department of Medical Microbiology, Leiden University Hospital, PO Box 9600, 2300, RC Leiden, The Netherlands aut NATIONALLICENCE 700 1- Mouton R. Department of Medical Microbiology, Leiden University Hospital, PO Box 9600, 2300, RC Leiden, The Netherlands aut NATIONALLICENCE 700 1- van Boven C. Department of Medical Microbiology, Leiden University Hospital, PO Box 9600, 2300, RC Leiden, The Netherlands aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/2(1996-02-01), 107-115 0934-9723 15:2<107 1996 15 10096 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer