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An emptying quiver: antimicrobial drugs and resistance.

Weber JT, Courvalin P - Emerging Infect. Dis. (2005)

View Article: PubMed Central - PubMed

Affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. jtw5@cdc.gov

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The lack of new drug classes is a consequence of difficulties in discovery of new compounds that has persisted for many years... However, since 2000, two new drug classes have been approved by the U.S. Food and Drug Administration... Whether this trend will continue is unclear and does not obviate the need for more new classes... Articles address antimicrobial resistance in pathogens from the community, healthcare settings, and agriculture, among children and adults, and in several countries... In the case of community-associated methicillin-resistant Staphylococcus aureus (MRSA), articles cover outbreaks in Uruguay and in a US hospital nursery and maternity unit, emergence of a particular clone in Canada, prevalence in US emergency department patients, characteristics of patients admitted to a Swiss hospital, and the severity of this infection in pediatric patients... One article estimates hospitalizations associated with MRSA infection... An article on Trypanosoma brucei gambiense describes the importance and difficulty in determining resistance in parasitic infections, which can have countrywide implications for treatment, control, and use of resources... This issue does not cover resistance in malaria, gonorrhea, and HIV infection... Several articles describe the importance of the appropriate use of antimicrobial drugs as well as the difficultly of enforcement... The hope of preserving the effectiveness of existing drugs through appropriate use as well as the urgent need for the development of new drugs are both represented by the artwork featured on the cover of this issue... We hope to promote greater awareness among our readers of the strong link between antimicrobial drug use and the development of resistance and to make clear that improving use in community, healthcare, and agriculture settings, combined with other strategies, is imperative if we are to confront effectively the further development and spread of antimicrobial resistance.

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Schematic representation of mechanisms of resistance to antimicrobial agents.
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Figure 1: Schematic representation of mechanisms of resistance to antimicrobial agents.

Mentions: Since the dawn of the antibiotic era, resistance has shadowed the success of infectious disease therapy. In his 1945 Nobel Prize acceptance speech, Alexander Fleming noted the danger of resistance: "It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body…. Moral: If you use penicillin, use enough" (1). Sixty years later, our understanding of resistance has grown vastly more sophisticated and the proliferation of new antimicrobial drugs has engendered an equally varied collection of resistance mechanisms (Figure 1). Resistance is now an important problem in virtually all areas of infectious diseases, including viral, bacterial, fungal, and parasitic diseases.


An emptying quiver: antimicrobial drugs and resistance.

Weber JT, Courvalin P - Emerging Infect. Dis. (2005)

Schematic representation of mechanisms of resistance to antimicrobial agents.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3367582&req=5

Figure 1: Schematic representation of mechanisms of resistance to antimicrobial agents.
Mentions: Since the dawn of the antibiotic era, resistance has shadowed the success of infectious disease therapy. In his 1945 Nobel Prize acceptance speech, Alexander Fleming noted the danger of resistance: "It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body…. Moral: If you use penicillin, use enough" (1). Sixty years later, our understanding of resistance has grown vastly more sophisticated and the proliferation of new antimicrobial drugs has engendered an equally varied collection of resistance mechanisms (Figure 1). Resistance is now an important problem in virtually all areas of infectious diseases, including viral, bacterial, fungal, and parasitic diseases.

View Article: PubMed Central - PubMed

Affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. jtw5@cdc.gov

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The lack of new drug classes is a consequence of difficulties in discovery of new compounds that has persisted for many years... However, since 2000, two new drug classes have been approved by the U.S. Food and Drug Administration... Whether this trend will continue is unclear and does not obviate the need for more new classes... Articles address antimicrobial resistance in pathogens from the community, healthcare settings, and agriculture, among children and adults, and in several countries... In the case of community-associated methicillin-resistant Staphylococcus aureus (MRSA), articles cover outbreaks in Uruguay and in a US hospital nursery and maternity unit, emergence of a particular clone in Canada, prevalence in US emergency department patients, characteristics of patients admitted to a Swiss hospital, and the severity of this infection in pediatric patients... One article estimates hospitalizations associated with MRSA infection... An article on Trypanosoma brucei gambiense describes the importance and difficulty in determining resistance in parasitic infections, which can have countrywide implications for treatment, control, and use of resources... This issue does not cover resistance in malaria, gonorrhea, and HIV infection... Several articles describe the importance of the appropriate use of antimicrobial drugs as well as the difficultly of enforcement... The hope of preserving the effectiveness of existing drugs through appropriate use as well as the urgent need for the development of new drugs are both represented by the artwork featured on the cover of this issue... We hope to promote greater awareness among our readers of the strong link between antimicrobial drug use and the development of resistance and to make clear that improving use in community, healthcare, and agriculture settings, combined with other strategies, is imperative if we are to confront effectively the further development and spread of antimicrobial resistance.

Show MeSH