prevalence of penicillin and macrolide resistance as first line empiric therapy for 𝑆𝑡𝑟𝑒𝑝𝑡𝑜𝑐𝑜𝑐𝑐𝑢𝑠 𝑃𝑛𝑒𝑢𝑚𝑜𝑛𝑖𝑎: a systematic review

Antibiotic resistance in streptococcus pneumoniae infection is responsible for 1.6 million deaths per year. the discovery of antimicrobials has reduced the morbidity and mortality of pneumococcal disease, but the use of inappropriate dosages has contributed to the emergence of resistant microbes. increasing microbial resistance means there are fewer treatment alternatives worldwide. antibiotics can safely be used to develop antibiograms that monitor resistance trends and guide infection treatment guidelines. this study aims to determine the effectiveness of penicillin and macrolide as broad-spectrum antibiotics for therapy and serotypes that cause resistance to streptococcus pneumoniae. the systematic review method database of the scientific research platform was systematically searched. this systematic review is registered with prospero id crd42023400159. this work showed that penicillin resistance was between 61.7% and 98%; the highest was 100%, and the lowest resistance was 10.5%. the resistant serotypes that appear are 6a, 6b, and 19a. while macrolide resistance is between 21% and 69.4%, the highest resistance is 100%, and the lowest resistance is 2%, with resistance-causing genes that often appear as ermb and mefa. conclusion data shows high penicillin resistance against streptococcus pneumoniae with frequently occurring serotypes 6a, 6b, and 19a, and the trend of resistance to macrolides is increasing with the causative genes ermb and mefa. these antibiotic usage recommendations are regulated by clear regulations