Bugs for the next century: the issue of antibiotic resistance.
OBJECTIVE
To address the issue of emerging antibiotic resistance and examine which organisms will continue to pose problems in the new century.


METHODS
Review of articles pertaining to bacteria recognised for increasing resistance.


RESULTS
Changing resistance patterns are correlated with patterns of antibiotic use. This results in fewer effective drugs against "old" established bacteria e.g. gram-positives such as Streptococcus pneumoniae and Staphylococcus aureus. Resistance in gram-negative bacteria is also steadily increasing. Nosocomial gram-negative bacteria are capable of many different resistance mechanisms, often rendering them multiply-resistant. Antibiotic resistance results in morbidity and mortality from treatment failures and increased health care costs.


CONCLUSIONS
Despite extensive research and enormous resources spent, the pace of drug development has not kept up with the development of resistance. As resistance spreads, involving more and more organisms, there is concern that we may be nearing the end of the antimicrobial era. Measures that can and should be taken to counter this threat of antimicrobial resistance include co-ordinated surveillance, rational antibiotic usage, better compliance with infection control and greater use of vaccines.
Ang
B S
BS
Department of Infectious Diseases, Communicable Disease Centre, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433.
D000900:Anti-Bacterial Agents / Q000276:immunology / Q000627:therapeutic use; D003141:Communicable Diseases / Q000188:drug therapy / Q000276:immunology; D004352:Drug Resistance, Microbial / Q000276:immunology*; D006801:Humans
D000900:Anti-Bacterial Agents