Pneumococcal disease is normally treated using antibiotics. Mild forms, such as uncomplicated ear or sinus infections, in healthy people may resolve without treatment or be treated with oral antibiotics. However, more serious pneumococcal disease, such as bacteraemia, pneumonia and meningitis, require hospitalisation and intravenous antibiotics.

Successful treatment of pneumococcal disease relies on the infection being caught early and treated promptly with antibiotics. However, Streptococcus pneumoniae resistance to treatment with antibiotics remains a concern in the UK and worldwide. In particular, there is concern that pneumococci are becoming increasingly resistant to penicillins and macrolides. For example, in 2003, 15% of invasive isolates in England and Wales reported to the Health Protection Agency (HPA) were resistant to erythromycin and 7% showed full or intermediate resistance to penicillin.

As pneumococcal bacteria become harder to treat because of this resistance, prevention of pneumococcal disease by immunisation becomes even more important. The use of vaccines coupled with prudent use of antibiotics are important if we are to see an impact on resistant pneumococci in the community. 

Successful treatment with antibiotics also depends on the infection being caught early and treated promptly. Initial symptoms of pneumococcal meningitis are sometimes not specific, sharing similarities with other common viral infections, e.g. colds. This can cause delays in diagnosis and impact the effectiveness of treatment.

Key points

• Pneumococcal disease is usually treated using antibiotics
• More serious pneumococcal disease, such as bacteraemia and pneumonia, often require hospitalisation and intravenous antibiotics
• Streptococcus pneumoniae resistance to treatment with antibiotics remains a concern in the UK and worldwide