TY  - CHAP
M1  - Book, Section
TI  - TREATMENT AND PROPHYLAXIS OF BACTERIAL INFECTIONS
A1  - Hooper, David C.
A1  - Shenoy, Erica S.
A1  - Varughese, Christy A.
A2  - Kasper, Dennis L.
A2  - Fauci, Anthony S.
PY  - 2017
T2  - Harrison's Infectious Diseases, 3e
AB  - Antimicrobial  agents  have  had  a  major  impact  on  human  health.  Together  with  vaccines,  they  have  contributed  to  reduced  mortality,  extended  lifespan,  and  enhanced  quality  of  life.  Among  drugs  used  in  human  medicine,  however,  they  are  distinctive  in  that  their  use  promotes  the  occurrence  of  drug  resistance  in  the  pathogens  they  are  designed  to  treat  as  well  as  in  other  “bystander”  organisms.  Indeed,  the  history  of  antimicrobial  development  has  been  driven  in  large  part  by  the  medical  need  engendered  by  the  emergence  of  resistance  to  each  generation  of  agents.  Thus,  the  careful  and  appropriate  use  of  antimicrobial  drugs  is  particularly  important  not  only  for  optimizing  efficacy  and  minimizing  adverse  effects  but  also  for  minimizing  the  risk  of  resistance  and  preserving  the  value  of  existing  agents.  Although  this  chapter  focuses  on  antibacterial  agents,  the  optimal  use  of  all  antimicrobials  depends  on  an  understanding  of  each  drug’s  mechanism  of  action,  spectrum  of  activity,  mechanisms  of  resistance,  pharmacology,  and  adverse  effect  profile.  This  information  is  then  applied  in  the  context  of  the  patient’s  clinical  presentation,  underlying  conditions,  and  epidemiology  to  define  the  site  and  likely  nature  of  the  infection  or  other  condition  and  thus  to  choose  the  best  therapy.  Gathering  of  microbiologic  information  is  important  for  refining  therapeutic  choices  on  the  basis  of  documented  pathogen  and  susceptibility  data  whenever  possible;  this  information  also  makes  it  possible  to  choose  more  targeted  therapy,  thereby  reducing  the  risk  of  selection  of  resistant  bacteria.  Durations  of  therapy  are  chosen  according  to  the  nature  of  the  infection  and  the  patient’s  response  to  treatment  and  are  informed  by  clinical  studies  when  they  are  available,  with  the  understanding  that  shorter  courses  are  less  likely  than  longer  ones  to  promote  the  emergence  of  resistance.  This  chapter  provides  specific  information  that  is  necessary  for  making  informed  choices  among  antibacterial  agents.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accessbiomedicalscience.mhmedical.com/content.aspx?aid=1141407255
ER  -