title: Rapid diagnostics and appropriate antibiotic use.
abstract: Most antibiotics are prescribed by physicians lacking postgraduate training in infectious diseases. As such, prescribing physicians have varying levels of interest and sophistication in thinking about how to use molecular and microbiological data to inform therapeutic choices. Strategies designed to modify physician antimicrobial-prescribing practices must therefore choose simplicity over complexity and must acknowledge our fundamental ignorance of many of the specifics of antibiotic-microorganism interactions. They must also acknowledge the critical nature of bacterial illnesses in hospitalized patients and the importance of delivering effective antimicrobial therapy early in the illness. "Back-end" strategies that evaluate therapy at defined intervals will be more readily accepted than strategies limiting physician choices early in the illness. It is therefore critical that we develop rapid and reliable microbiological assays, evidence-based recommendations on appropriate durations of therapy, and accurate surrogate markers of infection resolution.
authors: Louis Stokes Cleveland Veterans Affairs Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA. louis.rice@va.gov
authors: Louis B
authors: LB
authors: Rice
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy*; D003937:Diagnosis, Differential; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D013997:Time Factors; D014777:Virus Diseases / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents