Kucers’ The Use of Antibiotics 7th Edition PDF
42.01 MB PDF
Kucers’ encyclopedic report on the current status of virtually all antimicrobial agents is testimony to the extraordinary, un-ending progress in dealing with infectious diseases. Never theless, with unexplored or incompletely pursued opportunities, there are formidable challenges ahead. The most obvious new challenges and opportunities are antibiotic resistance, expanded pursuit of antiviral agents, the constant emergence of new infectious disease threats, and, possibly, manipulation of the microbiome.
A great advantage of most antimicrobial agents is that they are readily available, relatively inexpensive, usually short course, and generally well-tolerated. These advantages are also economic disincentives for new drug development. The result is extensive abuse with progressive increases in resistance rates of nearly all pathogens according to Mendelian laws of survival. Antimicrobial resistance has now reached a crisis stage with warnings for the “post-antibiotic era”. This problem was predicted in the 2006 publication Bad Bugs, Need Drugs (Talbot et al., 2006), but the concern was largely ignored by the medical community until it was declared a “crisis” a decade later by the CDC, WHO, and key world leaders, including President Obama (Institute of Medicine [US] Forum on Microbial Threats, 2010; Spellberg et al., 2008). The response to this crisis has been impressive in terms of new products for treatment of diverse infections, including those caused by resistant pathogens. For example, the number of new antibiotics approved by the FDA decreased to only one in the four year period of 2008–2012. This has increased dramatically to 10 new antibiotics in the last 4 years! (Gould and Bal, 2013). This progress has also included methods to dissuade antibiotic abuse with improved diagnostics, multiple evidence-based guidelines, new infection prevention methods, and new products to help distinguish bacterial vs. non-bacterial infections. In addition, the recent history of anti-infective development has expanded in multiple directions (Carlet et al., 2014)
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