Optimal Use of Modern Antibiotics: Emerging Trends

Development of new antimicrobial drugs is an essential component in the effort to remain ahead of emerging microbial resistance. However, when new antibiotics are used with unrestrained enthusiasm, a predictable consequence is the further expansion of resistance. This problem is well known to the infectious diseases specialist and is increasingly appreciated by the nonspecialist and the public. A far more sensible strategy is to identify new ways to use these drugs to increase the duration of their usefulness. New methods to optimize antibiotic selection, dose, and duration of therapy are being investigated, and application of some of these strategies has been shown to have a favorable impact on resistance. Much of the classic thinking of how to use antibiotics is changing, and these newer strategies may result in prolongation of the era of the “antibiotic miracle.” The emergence of pathogens with increased resistance to available antibacterials has historically been followed by de-velopment of “modern ” antibiotics with improved activity for these resistant isolates. After a variable period, resistance fre-quently emerges to these new antibiotics, which then leads to development of even more modern antibiotics, and the cycl