Abstract

Streptococcus pyogenes (S. pyogenes) is associated with a broad spectrum of diseases from mild to severe infections, particularly in children and young adults. On the other hand, proper antimicrobial treatment of S. pyogenes infections is important to prevent post-streptococcal complications. Therefore, the purpose of this first meta-analysis in Iran was to evaluate the prevalence of S. pyogenes antibiotic resistance among Iranian children. We identified all published studies related to S. pyogenes antibiotic resistance by searching Persian and English electronic databases by up to March 20, 2019. Search terms included S. pyogenes, children and Iran. Out of 1022 publications, twelve articles were eligible and included based on inclusion and exclusion criteria. Our analysis indicated the following prevalence pattern for S. pyogenes antimicrobial resistance in Iran: 4.2 to penicillin, 38.3 to amoxicillin, 5.4 to erythromycin, 12 to azithromycin, 12.6 to clarithromycin, 12.4 to clindamycin, 15.3 to rifampicin, 8.1 to ceftriaxone, 17.6 to cefixime, 36.9 to ampicillin, 14.1 to vancomycin, 8.4 to chloramphenicol, 30.4 to tetracycline, 8.8 to cefotaxime, 82.8 to trimethoprim/sulfamethoxazole, 39.6 to gentamicin, 11.9 to ofloxacin, 28.3 to carbenicillin, 3.1 to ciprofloxacin, 6.1 to imipenem, 18.2 to cephalothin, 57.6 to tobramycin, 49.3 to kanamycin, 79 to cloxacillin, 12.9 to cephalexin, 10.7 to cefazolin and 89.5 to amoxicillin– clavulanic acid. Our findings suggest that penicillin (in non-allergic children) as well as macrolides, lincosamides and narrow-spectrum cephalosporins (in penicillin-allergic children) as the treatments of choice in Iran. © 2020, Oman Medical Specialty Board. All rights reserved.