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Susceptibility testing was performed using standard National Committee for Clinical Laboratory Standards methodology on 335 S. pyogenes and 350 S. pneumoniae isolates. Macrolide resistance mechanism phenotypes were identified using double-disk diffusion. All S. pyogenes were penicillin sensitive, while 6.3% were macrolide resistant, the main mechanism of which was of M phenotype (96%). Approximately 51% of S. pneumoniae were penicillin non-susceptible. Macrolide resistance in S. pneumoniae accounted for 18.8%, the majority of which were M phenotype (91%). Low-level resistance mediated by mef-bearing strains predominated. Newer macrolides, including azithromycin, are still considered drugs of choice for empirical treatment of respiratory infection in such circumstances.<\/jats:p>","DOI":"10.1177\/147323000503300310","type":"journal-article","created":{"date-parts":[[2013,2,27]],"date-time":"2013-02-27T14:22:43Z","timestamp":1361974963000},"page":"349-355","source":"Crossref","is-referenced-by-count":12,"title":["Patterns of Macrolide Resistance Determinants among\n                    <i>S. pyogenes<\/i>\n                    and\n                    <i>S. pneumoniae<\/i>\n                    Isolates in Saudi Arabia"],"prefix":"10.1177","volume":"33","author":[{"given":"AM","family":"Shibl","sequence":"first","affiliation":[{"name":"King Saud University, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2005,5,1]]},"reference":[{"key":"bibr1-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1016\/S0732-8893(98)00155-2"},{"key":"bibr2-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.42.4.989"},{"key":"bibr3-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.43.8.1935"},{"key":"bibr4-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.39.10.2239"},{"key":"bibr5-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.43.1.48"},{"key":"bibr6-147323000503300310","doi-asserted-by":"publisher","DOI":"10.3201\/eid0506.990603"},{"key":"bibr7-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.7.2370-2372.2003"},{"key":"bibr8-147323000503300310","first-page":"29","volume":"95","author":"Hsueh PR","year":"1996","journal-title":"J Formos Med Assoc"},{"key":"bibr9-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/29.2.149"},{"key":"bibr10-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.6.1721-1729.2001"},{"key":"bibr11-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1179\/joc.1999.11.Supplement-2.5"},{"key":"bibr12-147323000503300310","doi-asserted-by":"publisher","DOI":"10.1179\/joc.2000.12.2.134"},{"key":"bibr13-147323000503300310","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing; 13th Informational Supplement. 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