008 - EFFECTS OF PRIOR ANTIBIOTIC USE ON NASOPHARYNGEAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE IN PATIENTS ADMITTED WITH PNEUMONIA TO PATAN HOSPITAL, NEPAL (ID 478)

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Abstract

Background

Administration of oral antibiotics by parents or front-line health providers, prior to admission to hospital with a clinical diagnosis of pneumonia is common in Nepal. We examined the difference in nasopharyngeal carriage of Streptococcus pneumoniae among children with a diagnosis of pneumonia, with and without prior exposure to antibiotics.

Methods

Nasopharyngeal swabs were obtained from children admitted with clinician diagnosed pneumonia (2 months – 14 years of age) from March 2014 to 2019. The swabs were transported to the lab in STGG (skim milk-tryptone-glucose-glycerin) medium and cultured for pneumococcus.

Results

Of the 2082 children with pneumonia, 613 (29.4%) did not receive any antibiotics prior to swabbing, 510 (24.5%) and 532 (25.6%) received prior antibiotics at home or in hospital, respectively. Of note, 427 (20.5%) children received both home and hospital antibiotics prior to swabbing. The pneumococcal carriage was 65.9% in cases without prior antibiotics. Carriage rates were lower in those who received home antibiotics (31.2%), those who received hospital antibiotics (23.9%), and in those who received antibiotics both at home and in the hospital (14.3%), p<0.0001.

Conclusions

Our results show an inverse relationship between antibiotic use and pneumococcal carriage. Access to antibiotics may lead to underestimation of nasopharyngeal pneumococcal carriage rates.

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