Extended Spectrum Macrolide Use is Highly Prevalent in the United States, and Increasing in Developing Countries

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Extended-spectrum macrolide sales are generally increasing in developing countries, and extended-spectrum macrolide antibiotics remain a high proportion of total macrolide use in the United States.  Why are the extended-spectrum drugs so popular in the U.S.?  Although overall antibiotic use in the U.S. has declined, pediatric azithromycin use has increased 9-fold between 1995 and 2006 and the drug is now the number one prescription for otitis media (middle ear infections) and acute respiratory tract infections.  This trend is alarming because it has been linked to the rise of resistant pneumonia-causing bacteria. In general, extended-spectrum antibiotics are particularly important to preserve because they are effective against a range of bacterial infections.