Risk factors for macrolide-resistant Streptococcus pneumoniae in children:
(1) age < 5 years
(2) attendance in day care center
(3) recurrent otitis media
(4) recent hospitalization
(5) previous macrolide use during the past 3 months
(6) nasopharyngeal carriage
Risk factors for macrolide-resistant Streptococcus pneumoniae in adults:
(1) age > 65 years
(2) working at a day care center
(3) recent hospitalization
(4) clonal dissemination in a health care facility (nursing home, hospital, etc.)
(5) previous macrolide use during the past 3 months
(6) recent middle ear or sinus infection
(7) recent exacerbation of chronic bronchitis treated with multiple antibiotics
Risk factors for macrolide-resistant Streptococcus pneumoniae based on the isolate:
(1) penicillin resistant
(2) serotype in 6A, 6B, 14, 19F or 23F
(3) high-prevalence of Streptococcus pneumoniae in the community
(4) macrolides frequently used in the community
