There are significant differences in antibiotic resistance patterns across geographical regions, with wide variations in S. pneumoniae resistant to b-lactams and macrolides. Many countries, particularly those of the Far East, have moderate to high levels of macrolide- and b-lactam resistance among S. pneumoniae. While geographical differences are certainly important in terms of resistance profiles, it has also become apparent that it is necessary to note differences in resistance profiles among specific patient groups. For example, a patient who has received a large number of antibiotics, possibly someone with chronic bronchitis or a child in day care has a much greater likelihood of having drug-resistant S. pneumoniae (DRSP), as opposed to someone who has not received antibiotics previously.