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The antibiotic challenge: Changing clinical management of infections
JAAPA, 05/07/09

Deasy J - The changing epidemiology and resistance patterns of bacteria are making effective treatment of bacterial infections more difficult. Antimicrobial therapy enhances the multiplication of existing drug-resistant bacteria and the exchange of resistance mechanisms among bacteria. Antibiotic administration builds drug resistance in the commensal bacteria that are part of the patient's normal flora as well as in the targeted pathogen, thereby creating a resistance reservoir. Monitoring drug-resistance patterns among pathogens, developing antibiograms for clinicians, and routinely updating the antibiograms are important actions institutions can take to increase awareness of antimicrobial resistance. Local antibiograms that are site-specific to the pathogen and that separate outpatients from inpatients are the most useful. The benefits versus the risks of prescribing antibiotics must be considered. Antibiotic administration puts the patient at risk for allergic reactions, adverse reactions, and drug-drug interactions, as well as increases the likelihood that a newly acquired bacterial infection will be caused by an antibioticresistant strain.

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