New problems in the treatment of infectious diseases

IT may seem a bit like looking a gift horse in the mouth to speak about problems in the treatment of infection when so many of them have already been solved by the recent developments in chemotherapy, developments un-paralleled in the whole history of medicine. Nevertheless, new problems have arisen which deserve our attention. Time permits consideration of only three, but they are major problems which have recently become the subject of concern among those responsible for the treatment of infection in our hospitals. The first is the rising incidence of infections caused by drug-resistant bacteria; the second, the increased numbers of unusual secondary infections in patients undergoing treatment with antibiotics. The third problem—a very recent one — has to do with the patient's response to infection as it is modified by treatment with ACTH or cortisone. No attempt will be made to discuss the toxic effect of any of the antibiotics or the allergic manifestations which appear in patients with natural or acquired hypersensitivity to the antibiotics. THE INCREASING INCIDENCE OF DRUG-RESISTANT INFECTIONS There can be little doubt that we have begun to encounter an increasing number of drug-resistant infections in our hospitals. In considering this problem one must be careful to distinguish the natural from the acquired resistance of microorganisms. Natural resistance or susceptibility to the action of each antimicrobial agent varies widely among bacterial species a