Effect of antibiotic pretreatment on resistance

Abstract

The emergence of bacterial resistance to antibiotics limits the efficacy of technical developments in the field of infectious diseases. This is particularly true for respiratory tract infections, which are by far the main reason for antibiotic use in developed countries. Antimicrobial resistance among respiratory pathogens involves both gram-positive (primarily Streptococcus pneumoniae) and gram-negative (Haemophilus influenzae, Moraxella catarrhalis, and the more rare enterobacteriaceae) microorganisms. A number of epidemiologic studies show a relationship between antibiotic use and antibiotic resistance, and how antibiotic pretreatment can reduce the range of effective drugs for optimal therapy of infections in general and of respiratory tract infections in particular. An appropriate use of antimicrobials is of crucial importance to limit the emergence and spread of bacterial resistance to antibiotics. This can be achieved by avoiding usage in nonspecific, probably viral, infections that are unlikely to be influenced by antibiotic therapy, and by using narrow-spectrum drugs to minimize selective pressure.