In Belgium, decreasing macrolide, lincosamide, streptogramins B, and tetracycline use during 1997-2007 correlated significantly with decreasing macrolide-resistant Streptococcus pyogenes during 1999-2009. Maintaining drug use below a critical threshold corresponded with low-level macrolide-resistant S. pyogenes and an increased number of erm(A)-harboring emm77 S. pyogenes with low fitness costs.
No takes yet. Share an insight, caveat, or question.
Heirstraeten et al. (2012) studied this question.