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We, therefore, assessed at a country level if there was a macrolide consumption threshold for the selection of a prevalence of macrolide resistance of over 5% in\n                    <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Treponema pallidum<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">Mycoplasma genitalium<\/jats:italic>\n                    . In this ecological-level analysis, we found evidence for a macrolide consumption threshold of 1.3 defined daily doses per 1,000 inhabitants per day (DID) for\n                    <jats:italic toggle=\"yes\">M. genitalium<\/jats:italic>\n                    , 1.8 DID for\n                    <jats:italic toggle=\"yes\">T. pallidum<\/jats:italic>\n                    , and 2.3 DID for\n                    <jats:italic toggle=\"yes\">S. pneumoniae<\/jats:italic>\n                    . Our results provide further motivation for macrolide stewardship campaigns that strive to reduce macrolide consumption to levels below at least 2 DID.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2020.0490","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T13:54:02Z","timestamp":1613570042000},"page":"1079-1086","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":26,"title":["Is There a Resistance Threshold for Macrolide Consumption? Positive Evidence from an Ecological Analysis of Resistance Data from\n                    <i>Streptococcus pneumoniae<\/i>\n                    ,\n                    <i>Treponema pallidum,<\/i>\n                    and\n                    <i>Mycoplasma genitalium<\/i>"],"prefix":"10.1177","volume":"27","author":[{"given":"Chris","family":"Kenyon","sequence":"first","affiliation":[{"name":"HIV\/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium."},{"name":"Department of Medicine, Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheeba S.","family":"Manoharan-Basil","sequence":"additional","affiliation":[{"name":"HIV\/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Van Dijck","sequence":"additional","affiliation":[{"name":"HIV\/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/383309"},{"key":"e_1_3_5_3_2","first-page":"441","article-title":"The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland","volume":"337","author":"Seppala H.","year":"1997","unstructured":"Seppala H., , Klaukka T., , Vuopio-Varkila J., , Muotiala A., , Helenius H., , Lager K., , and Huovinen P.. 1997. 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