West SK, Munoz B, Weaver J, Mrango Z, Dize L, Gaydos C, Quinn TC, Martin DL, 2016. Can we use antibodies to Chlamydia trachomatis as a surveillance tool for National Trachoma Control Programs? Results from a district survey. PLoS Negl Trop Dis 10: e0004352.
Ho DK, Sawicki C, Grassly N, 2015. Antibiotic resistance in Streptococcus pneumoniae after azithromycin distribution for trachoma. J Trop Med 2015: 917370.
Seidman JC, Coles CL, Silbergeld EK, Levens J, Mkocha H, Johnson LB, Muñoz B, West SK, 2014. Increased carriage of macrolide-resistant fecal E. coli following mass distribution of azithromycin for trachoma control. Int J Epidemiol 43: 1105–1113.
West SK, Moncada J, Munoz B, Mkocha H, Storey P, Hardick J, Gaydos CA, Quinn TC, Schachter J, 2014. Is there evidence for resistance of ocular Chlamydia trachomatis to azithromycin after mass treatment for trachoma control? J Infect Dis 210: 65–71.
Coles CL, Mabula K, Seidman JC, Levens J, Mkocha H, Munoz B, Mfinanga SG, West S, 2013. Mass distribution of azithromycin for trachoma control is associated with increased risk of azithromycin-resistant Streptococcus pneumoniae carriage in young children 6 months after treatment. Clin Infect Dis 56: 1519–1526.
Haug S et al. 2010. The decline of pneumococcal resistance after cessation of mass antibiotic distributions for trachoma. Clin Infect Dis 51: 571–574.
Bloch EM, West SK, Mabula K, Weaver J, Mrango Z, Munoz B, Lietman T, Coles C, 2017. Antibiotic resistance in young children in Kilosa district, Tanzania 4 years after mass distribution of azithromycin for trachoma control. Am J Trop Med Hyg 97: 815–818.
Keenan JD et al. MORDOR Study Group, 2018. Azithromycin to reduce childhood mortality in sub-Saharan Africa. N Engl J Med 378: 1583–1592.
CLSI, 2018. Performance Standards for Antimicrobial Susceptibility Testing, 28th edition. Wayne, PA: Clinical and Laboratory Standards Institute.
Leclercq R, Courvalin P, 2002. Resistance to macrolides and related antibiotics in Streptococcus pneumoniae. Antimicrob Agents Chemother 46: 2727–2734.
Hanage WP, Fraser C, Tang J, Connor TR, Corander J, 2009. Hyper-recombination, diversity, and antibiotic resistance in pneumococcus. Science 324: 1454–1457.
Landers TF, Cohen B, Wittum TE, Larson EL, 2012. A review of antibiotic use in food animals: perspective, policy, and potential. Public Health Rep 127: 4–22.
Caudell MA, Quinlan MB, Subbiah M, Call DR, Roulette CJ, Roulette JW, Roth A, Matthews L, Quinlan RJ, 2017. Antimicrobial use and veterinary care among agro-pastoralists in northern Tanzania. PLoS One 12: e0170328.
WHO, 2016. Antimicrobial Resistance. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/mediacentre/factsheets/fs194/en/. Accessed September 24, 2017.
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Mass drug administration (MDA) for trachoma control using azithromycin has generated concern for the development of resistant organisms. However, the contribution from azithromycin available in local pharmacies has not been studied. In Kilosa district, Tanzania, MDA stopped over 4 years ago, and this study sought to determine the availability of azithromycin in local pharmacies and correlate it with azithromycin resistance in children born after MDA. A cross-sectional survey was conducted in 644 randomly selected hamlets in Kilosa district, in which the presence of a pharmacy and the availability of azithromycin and erythromycin were determined. In 30 randomly selected hamlets, a random sample of 60 children less than 5 years were tested for azithromycin-resistant Streptococcus pneumoniae (Spn) and Escherichia coli (Ec), from nasopharyngeal and rectal swabs, based on disk diffusion criteria. Only 26.6% of hamlets had a pharmacy. Azithromycin and erythromycin were available in 30.8% and 89.1% of pharmacies closest to the hamlets, respectively. In the 30 communities tested for resistance, the overall prevalence of azithromycin-resistant Spn isolates was 14%. Six of seven (87%) hamlets where azithromycin was available had resistant Spn, compared with 14 of 23 (61%) hamlets without availability. Similarly, six of seven (87%) hamlets where azithromycin was available had resistant Ec isolates compared with 21 of 23 (70%) hamlets without availability. However, the differences were not statistically significant (P = 0.46 and 0.49, respectively). The availability of azithromycin in pharmacies in the district was limited, and a strong correlation with azithromycin-resistant Spn or Ec was not observed.
Financial support: Grant from the Bill & Melinda Gates Foundation. D. A.’s travel was supported by a grant from the Dean of Student Affairs’ office at the Johns Hopkins School of Medicine.
Authors’ addresses: Derick Ansah, Jerusha Weaver, Beatriz Munoz, and Sheila K. West, Dana Center for Preventive Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD, E-mails: firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, and email@example.com. Evan M. Bloch, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, E-mail: firstname.lastname@example.org. Christian L. Coles, Johns Hopkins Bloomberg School of Public Health, International Health, Baltimore, MD, E-mail: email@example.com. Thomas Lietman, Proctor Foundation, University of California San Francisco, San Francisco, CA, E-mail: firstname.lastname@example.org.