Bugs versus drugs: addressing the pharmacist's challenge.
OBJECTIVE
To address how the high endemic levels of antimicrobial resistance and multidrug resistance in hospitals have challenged clinicians to select appropriate therapy for effectively treating bacterial infections among seriously ill patients.


CONCLUSIONS
Among gram-positive bacterial infections, differentiating between healthcare-associated and community-associated methicillin-resistant Staphylococcus aureus infections is becoming more difficult and can seriously impact therapeutic strategies and hence outcomes. Furthermore, the rising prevalence of multidrug-resistant gram-negative bacterial infections is increasing the pressure on proper antimicrobial selection given the dearth of new antimicrobial agents under development. Optimized dosing strategies will be instrumental in minimizing emergence of resistance and preserving the utility of currently available agents. Antimicrobial stewardship programs in conjunction with stringent infection control policies will be critical in improving the appropriate use of antimicrobials while reducing the spread of nosocomial pathogens.


CONCLUSIONS
Addressing the challenges of antimicrobial resistance in hospitals will require a multidisciplinary approach, with clinical pharmacists taking a proactive role in ensuring the appropriate use of antimicrobials.
Burgess
David S
DS
College of Pharmacy, The University of Texas at Austin, USA. burgessd@uthscsa.edu
Rapp
Robert P
RP
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D017723:Drug Utilization Review; D006801:Humans; D033183:Interdisciplinary Communication; D010348:Patient Care Team / Q000458:organization & administration; D010595:Pharmacists; D010607:Pharmacy Service, Hospital; D014481:United States / Q000453:epidemiology
D000900:Anti-Bacterial Agents