Antimicrobial Chemotherapy

Strategies to Minimize Antibiotic Resistance

“…The mortality and morbidity from bacterial diseases have fallen so low that they are no longer among the important unsolved problems of medicine. These accomplishments are widely known and appreciated.” [218]. In those days, Jawetz was unaware of the enormous ability of bacteria to adapt easily to new environments, such as the exposure of antibiotics.…”

Virulence factors and their mechanisms of action: the view from a damage–response framework

“…For example, by the 1950s the introduction of broad spectrum antimicrobial therapy and corticosteroids was associated with candidaiasis, a disease that was extremely rare earlier in the century (Jawetz 1956), and the widespread use of intravenous catheters was associated with Staphylococcus epidermidis bacteremia. The emergence of diseases caused by commensal microbes in hosts with immune impairment and/or altered skin and mucosal surfaces posed a direct challenge to microbe-centric views of microbial pathogenesis, while illustrating the critical role played by the host in the development of disease.…”

Why Did It Take the Infectious Diseases Society of America So Long to Address the Problem of Antibiotic Resistance?

“…The promotion of "antibiotic stewardship" is a critical role for the IDSA, and considerable efforts are ongoing. This guidance [3] is just one example of multiple current efforts. However, the IDSA is an organization of ∼9000 professionals and currently has no regulatory authority for "antibiotic stewardship" for the 11,000,000 licensed physicians and health care workers who are entitled to use antibiotics in any way that they feel is appropriate.…”

“…In the 1950s, Ernest Jawetz and Maxwell Finland warned about the overzealous promotion of antibiotics and the potential for developing antibiotic resistance [3,4]. In the 1970s, I and others reported that, in approximately one-half of cases in which antibiotics were used in hospitals, they were used inappropriately because of an incorrect choice of antibiotic, dose, or duration of treatment [5]; the US Veterans Administration published audit guidelines for the use of antibiotics [6]; and the National Institutes of Health held a symposium on the problems of antibiotic use [7].…”