CHAPTER 45. Prevention of Antimicrobial Resistance: Current and Future Strategies by Cesar A. Arias and Adolf W. Karchmer
ABSTRACT
Antibiotic-resistant organisms are now commonly found in centers dedicated to the care of cancer patients, but most worrisome, have been increasingly reported as a cause of serious infections in community settings, even in healthy individuals with no apparent contacts with the health system. The discovery and development of antimicrobial agents is one of the most significant advances in the history of clinical medicine. The delivery of aggressive invasive and immunosuppressive medical care, as occurs with cutting edge therapies today, will not be possible in the absence of effective antimicrobial agents. This concept is particularly crucial in the care of cancer patients who receive complex chemotherapeutic regimens that damage their immune system. The emergence of increasingly multi-drug resistance bacteria is a limiting challenge to successful cancer therapy and is accentuated by the absent development of new antimicrobials that are active against the most recalcitrant bacterial species. A concerted and integrated effort among clinicians, hospital epidemiologists, academic medical centers, pharmaceutical companies and government agencies is essential if the “tide’ of antimicrobial resistant microorganisms that threaten the future of modern medical care is to be arrested.