Antibiotic Policies: Fighting Resistance

1. Front Matter

   Pages I-XIII

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2. Consequences of Antimicrobial Chemotherapy: Overgrowth, Resistance, and Virulence

   • Stephanie J. Dancer

   Pages 1-15

3. The Process of Antibiotic Prescribing: Can It Be Changed?

   • Jos W.M. van der Meer, Richard P.T.M. Grol

   Pages 17-27

4. Cultural and Socioeconomic Determinants of Antibiotic Use

   • Stephan Harbarth, Dominique L. Monnet

   Pages 29-40

5. Electronic Prescribing

   • Mical Paul, Roberto Cauda, Leonard Leibovici

   Pages 41-67

6. Prevalence Surveys of Antimicrobial Use in Hospitals: Purpose, Practicalities, and Pitfalls

   • R. Andrew Seaton

   Pages 69-81

7. Antibiotic Use in Hospitals in the United States SCOPE-MMIT Antimicrobial Surveillance Network

   • Amy Pakyz, Ron Polk

   Pages 83-91

8. New Hospital Initiatives in Fighting Resistance

   • Fiona Cooke, Alison Holmes

   Pages 93-112

9. Antimicrobial Resistance: Preventable or Inevitable?

   • Duygu Yazgan Aksoy, Mine Durusu Tanriover, Serhat Unal

   Pages 113-133

10. Fighting Antimicrobial Resistance in the Mediterranean Region

    • Michael A. Borg

    Pages 135-148

11. Cystic Fibrosis—Coping with Resistance

    • Oana Ciofu, Niels Høiby

    Pages 149-174

12. Community-Acquired Pneumonia—Back to Basics

    • Marc J.M. Bonten, Jan Jelrik Oosterheert

    Pages 175-191

13. Hospital-Acquired Pneumonia: Diagnostic and Treatment Options

    • Marìa V. Torres, Patricia Mu≁oz, Emilio Bouza

    Pages 193-207

14. Optimizing Antimicrobial Chemotherapy in the ICU—A Review

    • Ian M. Gould

    Pages 209-222

15. Risk Assessment for Methicillin-Resistant Staphylococcus aureus

    • Evelind Tacconelli

    Pages 223-236

16. What Do We Do with Methicillin-Resistant Staphylococcus aureus in Surgery?

    • Giorgio Zanetti

    Pages 237-251

17. Control of Healthcare-Associated Methicillin-ResistantStaphylococcus aureus

    • Jan A.J.W. Kluytmans, Bram M.W. Diederen

    Pages 253-269

18. Back Matter

    Pages 271-285

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In 1971, I started a fellowship in infectious diseases and medical microbiology at the Channing Laboratory of the Harvard Medical Service at Boston City Hospital. My mentor, Dr. Maxwell Finland, had encouraged me to return there from the Center for Disease Control (as CDC was known then), where I had studied inf- tious diseases epidemiology and hospital-associated infection epidemiology, with the idea that we would review the demographic patterns of bacteremia and several other infections during Dr. Finland’s long tenure at the hospital. We did so, but I was surprised to find that he also invited me to help with the assessment of the success or failure of the programs to control antimicrobial use that he and c- leagues had put into place at the hospital over several years. The paper describing that review finally was published in 1974, after a long and tortuous process of review at several journals. Several reviewers felt that such attempts to improve use amounted to interference with the patient’s physician to do what was best. Others felt that such programs focused incorrectly on a subject other than treating the current patient. Fortunately, today, it is clear that antimicrobial resistance results in major part, but not entirely, from the ways that we use antimicrobial agents, and that the ov- all interests of patients in general, as well as those of society, are well served by efforts to use these drugs as well as possible.

• antibiotic use
• antibiotics
• antimicrobial
• antimicrobial resistance
• infection
• infection control
• infectious diseases

• Department of Medical Microbiology, Aberdeen Royal Infirmary, Foresterhill, Australia

  Ian M Gould

• Department of General Internal Medicine & Nijmegen University Centre for Infectious Diseases, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands

  Jos WM Meer

Policies and ethics