Semin Respir Crit Care Med 2000; 21(1): 0003-0008
DOI: 10.1055/s-2000-9925
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Antibiotic Resistance: A Historical Perspective

Burke A. Cunha
  • Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, and State University of New York School of Medicine, Stony Brook, New York
Further Information

Publication History

Publication Date:
31 December 2000 (online)

 

ABSTRACT

Antibiotic resistance is an increasing problem worldwide. Much of the antibiotic resistance occurs among community-acquired and nosocomial pulmonary pathogens. Antibiotic resistance may be classified as relative or absolute, which has important therapeutic implications. Considerable misunderstanding exists with regard to the factors that are responsible for antibiotic resistance. Misuse and overuse of antibiotics should be avoided; however, high volume of antibiotic use alone does not result in resistance. Antimicrobial resistance is agent specific and not related to antibiotic class. The antibiotics associated with a high resistance potential include ampicillin, cefamandole, ceftazidime, imipenem, ciprofloxacin, and vancomycin. The use of these antibiotics should be restricted to prevent generalized resistance problems. The substitution on the formulary of ``vacuum cleaner'' antibiotics, along with effective infection control measures, can eliminate resistance problems in institutions. The key to controlling antibiotic resistance is to selectively use antibiotics with a low resistance potential and restrict those with a high resistance potential.

KEYWORD

Antibiotic resistance - control of resistance - antibiotic restriction

REFERENCES

  • 1 Kunin C M. Resistance to antimicrobial drugs-a worldwide calamity.  Ann Intern Med . 1993;  118 557-561
    PubMedGoogle Scholar
  • 2 Cunha B A. Problems arising in antimicrobial therapy due to false susceptibility testing.  J Chemother . 1997;  9(suppl) 24-35
    PubMedGoogle Scholar
  • 3 Fraimow H S, Aburtyn E. Pathogens resistant to antimicrobial agents.  Infect Dis Clin North Am . 1995;  9 497-529
    PubMedGoogle Scholar
  • 4 Murray B E. Vancomycin resistant enterococci.  Am J Med . 1997;  102 284-293
    CrossrefPubMedGoogle Scholar
  • 5 Leclerq R, Courvalin P. Resistance to glycopeptides in enterococci.  Clin Infect Dis . 1997;  24 545-556
    PubMedGoogle Scholar
  • 6 Cunha B A. Antibiotic resistance: Control strategies.  Crit Care Clin . 1998;  309-328
    CrossrefPubMedGoogle Scholar
  • 7 Cunha B A. Antibiotic resistance.  Drugs for Today . 1998;  34 691-698
    PubMedGoogle Scholar
  • 8 Shea K W, Cunha B A. Doxycycline activity against Streptococcus pneumoniae Chest .  1995;  108 1175-1176
    PubMedGoogle Scholar
  • 9 Cunha B A. New uses of older antibiotics.  Postgrad Med . 1997;  100 66-88
    PubMedGoogle Scholar
  • 10 Cunha B A. Prevention of aminoglycoside resistance by the use of amikacin.  Adv Ther . 1987;  4 33-39
    PubMedGoogle Scholar
  • 11 Cunha B A, Gill M V. Cefepime.  Med Clin North Am . 1995;  79 721-732
    PubMedGoogle Scholar
  • 12 Quintiliani R, Nicolau D P, Nightingale C H. Clinical relevance of penicillin-resistant Streptococcus pneumoniae with particular attention to therapy with ceftizoxime, cefotaxime, and ceftriaxone.  Infect Dis Clin Prac . 1997;  5(suppl) S37-S41
    PubMedGoogle Scholar
  • 13 Horton J, Pankey G A. Polymyxin B.  Med Clin North Am . 1982;  66 135-1421
    PubMedGoogle Scholar
      >