The DRSP prevalence rate for the Maltese Islands was investigated. Consecutive samples were obtained, both from adults and children, from September 2000 through April 2002. Penicillin-intermediately-resistant isolates amounted to 27%, erythromycin-resistant isolates 31%, and clindamycin-resistant isolates 19%. The oxacillin disk was found to be an effective screening method for the detection of penicillin resistance. An association was found in patients who had DRSP, as well as diabetes and/ or cardiovascular disease. Finally, an investigation of the local antibiotic consumptions over the period 1997-2000, for the National Health Service was conducted. The highest consumption rates were obtained with co-amoxiclav, amoxicillin, erythromycin, cephalexin and ciprofloxacin. The results obtained here call for more judicious use of antibiotics. In addition, the setting up of a local DRSP surveillance unit is mandatory. Moreover, the use of molecular techniques to investigate specific genes, such as ermAM and mefE associated with macrolide-resistance, should be introduced as part of investigational laboratory work.peer-reviewe
