Recent developments in antibiotic treatment.
Antibiotic resistance of gram-positive and gram-negative bacteria remains a major challenge for clinicians treating HAP. Since the recent release of linezolid and QD, treatment options for resistant gram-positive bacteria have improved. The development of new substances continues and it is hoped that some of them will be available soon. Investigation has centered on gram-positive bacteria, although multiresistant gram-negative pathogens, such as A haumanii, S maltophilia, and resistant P aeruginosa, are of major clinical relevance. New treatment options are unfortunately not in sight. No antibiotic, however, is a miraculous magic wand against resistant bacteria. The bugs are smart; they have been on this world far longer than humans. Regardless of how innovative the mechanism of action of new substances is, resistance will emerge. The solution is certainly not a nihilistic approach leading to a fearful restriction in the use of new substances. No antibiotic, regardless of its potency, can free the clinician from keeping the difficult balance between individual undertreatment and general overtreatment.
Department for Immunology and Infectious Diseases (Pneumologie I), City Hospital Heckeshorn, Zentralklinik Emil von Behring, Affil. Free University Berlin, zum Heckeshorn 33, 14109 Berlin, Germany. haloheck@zedat.fu-berlin.de
Andrés
A
de Roux
Hartmut
H
Lode
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001682:Biological Availability; D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000188:drug therapy*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000472:pathogenicity; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000472:pathogenicity; D006207:Half-Life; D006801:Humans; D018410:Pneumonia, Bacterial / Q000188:drug therapy*
D000900:Anti-Bacterial Agents