Objectives.

The purpose of this study was to determine the susceptibility of the S. pneumoniae causing acute sinusitis (AS) in adults.

Methods.

A total of 142 S. pneumoniae isolated from aspirates obtained via maxillary sinus punctures in Smolensk (S), Moscow (M) and St. Petersburg (SP) were studied. Susceptibility to penicillin G, amoxicillin, amoxicillin/clavulanate, cefotaxime, cefepime, erythromycin, azithromycin, clarithromycin, clindamycin, tetracycline, levofloxacin, moxifloxacin, chloramphenicol and co-trimoxazole was determined by broth microdilution according to NCCLS (2003) guidelines.

Results.

The most active antimicrobials were amoxicillin, amoxicillin/clavulanate, cefotaxime, cefepime, levofloxacin and moxifloxacin to which no resistance was found. Intermediate resistance to penicillin G was 4.2% (6.5, 4.3 and 1.8% in S, M and SP, respectively). Proportion of non-susceptible strains to macrolides, chloramphenicol and clindamycin was 1.4% (S, 0%; M, 4.3%; SP, 1.8%), 4.9% (S, 3.2%; M, 4.3%; SP, 7.0%) and 0.7% (S, 0%; M, 0%; SP, 1.8%), respectively. The highest percentage of non-susceptible isolates was found to tetracycline and co-trimoxazole – 28.2% (S, 30.6%; M, 30.4%; SP, 24.6%) and 41.6% (S, 35.4%; M, 30.4; SP, 52.7%), respectively.

Conclusion.

S. pneumoniae retained their susceptibility to aminopenicillins, III–IV generation cephalosporins and respiratory fluoroquinolones. The highest non-susceptibility was found to tetracycline and co-trimoxazole, substantially compromising possibility of their usage for empiric therapy of AS.