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This contribution illustrates reasons, spread, and mechanisms of development of resistance especially in gram-positive microorganisms such as methicillin resistant staphylococcus aureus (MRSA) or vancomycin resistant enterokoccus (VRE). Possibilities of overcoming these are described as well as strategies for antibacterial therapy with recently developed antibiotics against multiple resistant microorganisms. These are linezolid as an oxazolidinone, daptomycin as a lipopeptid and tigecyclin as a new glycylcycline, which are already on the market or will be launched soon in Germany. Differences in magnitude and frequency of still existing resistances between hospital and practice are discussed with respect to their importance for the internal physician.

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